Meta-analysis of telemonitoring to improve HbA1c levels: Promise for stroke survivors

Publication date: May 2015 Source:Journal of Clinical Neuroscience, Volume 22, Issue 5 Author(s): Bryan A Lieber , Blake Taylor , Geoff Appelboom , Kiran Prasad , Sam Bruce , Annie Yang , Eliza Bruce , Brandon Christophe , E. Sander Connolly Jr. Monitoring glycemic control is useful not only in the primary prevention of stroke in diabetics, but also in the rehabilitation from and secondary prevention of stroke. In an often functionally and neurocognitively impaired population, however, poor compliance with treatment regimens is a major problem. Wireless, telemonitoring glucometers – often integrated into the patient’s healthcare system – offer a solution to the compliance issue. We sought to evaluate the effectiveness of telemonitoring technologies in improving long-term glycemic control. A search on www.clinicaltrials.gov, using keywords such as “telemonitoring” and “self-care device” was performed, and five trials were identified that compared hemoglobin A1c (HbA1c) levels of a group receiving standard care (controls) to a group receiving a telemonitoring intervention. Four of the five studies showed a greater reduction in HbA1c in the intervention group compared to controls at 6months, although only one was statistically significant. There was considerable heterogeneity between studies (I2 =69.5%, p =0.02), and the random effects model estimated the aggregate effect size for mean difference in reduction of HbA1c levels to be 0.08% (95% confidence...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research