Inventi Impact: Cardiovascular Nursing

Inventi:hcvn/22300/17

An Evaluation of the Telehealth Facilitation of Diabetes and Cardiovascular Care in Remote\nAustralian Indigenous Communities: - Protocol for the Telehealth Eye and Associated Medical\nServices Network [TEAMSnet] Project, A Pre-Post Study Design

Background: Despite substantial investment in detection, early intervention and evidence-based treatments, current\nmanagement strategies for diabetes-associated retinopathy and cardiovascular disease are largely based on real-time\nand face-to-face approaches. There are limited data re telehealth facilitation in type 2 diabetes management. Therefore,\nwe aim to investigate efficacy of telehealth facilitation of diabetes and cardiovascular disease care in high-risk\nvulnerable Aboriginal and Torres Strait Islanders in remote/very remote Australia.\nMethods: Using a pre-post intervention design, 600 Indigenous Australians with type 2 diabetes will be recruited from\nthree primary-care health-services in the Northern Territory. Diabetes status will be based on clinical records. There will\nbe four technological interventions: 1. Baseline retinal imaging [as a real-time patient education/engagement tool and\ntelehealth screening strategy]. 2. A lifestyle survey tool administered at ââ?°Ë? 6-months. 3. At ââ?°Ë? 6ââ?¬â? and 18-months, an\nelectronic cardiovascular disease and diabetes decision-support tool based on current guidelines in the Standard\nTreatment Manual of the Central Australian Rural Practitionerââ?¬â?¢s Association to generate clinical recommendations.\n4. Mobile tablet technology developed to enhance participant engagement in self-management. Data will\ninclude: Pre-intervention clinical and encounter-history data, baseline retinopathy status, decision-support and\nsurvey data/opportunistic mobile tablet encounter data. The primary outcome is increased participant adherence\nto clinical appointments, a marker of engagement and self-management. A cost-benefit analysis will be performed.\nDiscussion: Remoteness is a major barrier to provision and uptake of best-practice chronic disease management.\nTelehealth, beyond videoconferencing of consultations, could facilitate evidence-based management of diabetes and\ncardiovascular disease in Indigenous Australians and serve as a model for other conditions.