Telemedicine in primary care for patients with Chronic conditions: The valcrònic quasi-experimental study

Abstract

Background: The increase of chronic diseases prevalence has created the need to adapt care models and to provide greater home supervision. Objective: The objective of our study was to evaluate the impact of telemonitoring on patients with long-term conditions at high risk for rehospitalization or an emergency department visit, in terms of target disease control (diabetes, hypertension, heart failure, and chronic obstructive pulmonary disease). Methods: We conducted a quasi-experimental study with a before-and-after analysis to assess the effectiveness of the ValCronic program after 1 year of primary care monitoring. The study included high-risk patients with 1 or more of the following conditions: Diabetes, high blood pressure, heart failure, and chronic obstructive pulmonary disease. We assessed risk according to the Community Assessment Risk Screen. Participants used an electronic device (tablet) to self-report relevant health information, which was then automatically entered into their eHealth record for consultation. Results: The total sample size was 521 patients. Compared with the preintervention year, there were significant reductions in weight (82.3 kg before vs 80.1 kg after; P=.001) and in the proportion of people with high systolic (.140 mmHg; 190, 36.5% vs 170, 32.6%; P=.001) and diastolic (.90 mmHg; 72, 13.8% vs 40, 7.7%; P=.01) blood pressures, and hemoglobin A1c .8% (186, 35.7% vs 104, 20.0%; P=.001). There was also a decrease in the proportion of participants who used emergency services in primary care (68, 13.1% vs 33, 6.3%; P