Persons with Diabetes will Contribute to Assess the Global Impact of Telemedicine Services

Diabetes mellitus affects more than 366 million patients worldwide, according to the International Diabetes Federation (IDF), but the prevalence and incidence of the disease are still growing in conjunction with increased obesity rates and sedentary lifestyle. It is projected that in the next 20 years more than one in ten adults will be affected by diabetes. However, the most important issue is that the disease, although silent, is associated with serious complications. Diabetes is the leading cause of cardiovascular diseases including stroke, end-stage renal disease, blindness and amputation. It is also responsible for more than 4.6 million deaths per year. The attendant economic burden for health-care systems and individual patients is enormous, owing to the costs associated with treatment and diabetes complications.

The International Diabetes Federation (IDF) has proposed a National Diabetes Programme with three core elements:
a) Primary prevention: preventing the development of risk factors;
b) Secondary prevention: preventing the development of diabetes; and finally
c) Tertiary prevention: preventing the development of complications through early diagnosis and effective monitoring, treatment and care of people with diabetes.

Telemedicine can contribute significantly in tertiary prevention by providing an effective approach for coaching-education about the disease, improving compliance with medication and recommendations, supporting timely transmission and remote interpretation of patients' data for follow-up and preventive interventions, and finally meeting safely the target for glycaemic control.

Small clinical trials of different telehealth services have shown neutral or positive results in glycaemic control, hospitalizations and quality of life, but in the UK an evaluation of the Whole System Demonstrator trial reported that telecare improves at least quality of life and independence in a cohort of patients including diabetics. However, further research is required to give a more precise assessment of telemedicine applications and this is what the project Renewing Health is about.

RENEWING HEALTH (www.renewinghealth.eu) is a project co-funded by the European Commission. It will evaluate whether the introduction of telemedicine applications to patients with Type 2 diabetes, both with and without health counselling, produces benefits in terms of clinical outcomes such as HbA1c, health-related quality of life (HRQoL), self-management and empowerment.

In addition, the economic and organisational impact of the new services will be assessed, together with their acceptability by patients and health professionals. More than 1.800 diabetics have already been recruited. Recruitment will be completed by the end of the year, and the first results are scheduled to be reported at the end of 2013.

A description of all services under evaluation can be found at: www.renewinghealth.eu/en/services

About RENEWING HEALTH
RENEWING HEALTH is the largest project ever launched in Europe for evaluating the impact of telemedicine in the management of chronic patients in home settings. It is a multicenter randomized clinical trial, partially funded by EU, designed for the evaluation of telemedicine in three main pathologies: heart failure, COPD, and diabetes. The target population is about 7148 patients, with more than 2000 diabetics and a one year follow-up.

In fact, the project expands a variety of pre-existing telemonitoring and health coaching services with the objective to produce high level evidence for healthcare authorities and the medical community and to support future adoption of the services into routine clinical practice.

The Regions which contributes to the project are:

  • Veneto (Italy)
  • Syddanmark (Denmark)
  • Norrbotten (Sweden)
  • Northern Norway (Norway)
  • Catalonia (Spain)
  • South Karelia (Finland)
  • Thessaly (Greece)
  • Carinthia (Austria)
  • Berlin (Germany)

They are supported by these European associations

  • European Patient's Forum
  • European Health Telematics Association
  • Continua Health Alliance

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