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Tennessee Medicine E-Journal

Abstract

Objective: To investigate the efficacy of a telemedicine-based endocrine consultative service in improving outcome measures in rural patients with endocrine disorders.

Materials and Methods: Patients from five rural communities were referred by their primary care providers (PCPs) to the Telemedicine Unit of the University of Tennessee Health Science Center (UTHSC). Patients and the telemedicine studio were connected via videoconference using Polycom VSX 7000 video cameras, television monitors and dedicated lines to transmit video and audio electronic records. Recommendations regarding management were sent to the PCP via fax. Data were summarized using mean and standard deviations for continuous variables, and percentages for categorical variables. Statistical analysis was performed using Student’s t-test for continuous variables and Chi square test for categorical variables.

Results: Sixty-six patients aged 53.8 ± 15.5 years, 73 percent of whom were females, were seen over a three-year period. Of the 66 patients seen, 53 percent had type 2 diabetes while 45 percent and 41 percent had dyslipidemia and hypertension respectively; 30 percent were seen for thyroid disease and 12 percent had mineral or bone disease. Available data showed significant reduction in hemoglobin A1c after six months [9.1 ± 1.3 to 7.5 ± 1.4%; (P<0.002)] as well as improvement in mean lipid profile [total cholesterol (P=0.027), HDL (P=0.038) and triglyceride (P=0.046), with a trend towards reduction in LDL (P=0.085)]. Ninety-seven percent of subjects were comfortable with receiving care through telemedicine.

Conclusion: A telemedicine-based endocrine consultative service utilizing videoconference technology was effective in improving outcome measures in patients with diabetes and other endocrine disorders.

Abbreviations: PCP - Primary care providers; HbA1c - Hemoglobin A1c; HDL - High density lipoprotein cholesterol; LDL - Low density lipoprotein cholesterol

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