Telehealth Group Proposal
Telehealth Group Proposal
Diabetes is a common cause of morbidity and mortality across the world. The International Diabetes Federation reports that in 2013 the number of deaths caused by this disease has reached 5,1 million (International Diabetes Federation, 2015). Although the problem is more common in low-income countries, it is also relevant to the US, where an increase in diabetes cases was observed during the last decade. The number of American patients with this diagnosis is 29,1 million people or 9,3% of population (“National diabetes statistics report, 2014,” n. d.). The timely diagnosis and consequent proper treatment are the key factors necessary to ensure the high quality of life for people with diabetes and avoid various complications or morbidity. Those who are diagnosed with diabetes have to follow certain rules to manage their lives properly. In addition to healthy eating, physical activity, and medications, monitoring blood glucose levels is an important procedure that reduces the risks of such complications as hypoglycemia, low blood glucose, or other problems with organs be it the eyes, nerves, kidneys, or other. The problem is that it is not always easy to identify the emergency cases early enough to avoid the negative consequences. The current technology offers such effective means as wearable sensors to identify the blood glucose levels and detect emergency cases as early as possible (Piwek et al., 2016). The hypothesis of the current study is that the wearable devices which are a part of the telehealth field must get a wider usage, and become a considerable influence on the decrease of the diabetes-related complications with health. The paper aims to identify the positive outcomes of wearable sensors, the convenience of their usage for patients, the level of the patients’ awareness about the opportunities provided by technology, and evidence for the effectiveness of the devices’ application.
Patients with diabetes have wearable sensors for glucose level detection, which leads to decreased levels of complications. In this case, P= patients with diabetes, I= wearable sensors, C= glucose detection at the hospital, O= decreased number of complications of patients’ conditions.
CGM is the major source of information regarding the direction, duration, frequency, and underlying causes of blood glucose levels changes (Klonoff, 2005). Therefore, it must be considered as the major mean to find the best recommendation for each patient. There is a great number of empirical evidences that point out the crucial role of glucose level monitoring for type 1 and type 2 diabetes treatment. Beck (2010) has conducted detailed research to show that continuous glucose monitoring must be conducted in both clinical and home settings. Mainly, this procedure ensures hypoglycemia reduction among all age groups of the patients. Many scholars emphasize self-monitoring as the crucial step on the way to hypoglycemia treatment. The research conducted by Martin et al. (2005) has provided evidence that regular self-monitoring of blood glucose is strongly associated with decreased mortality rates among patients with type 2 diabetes. Relying on the 12-months investigation, Beck et al. (2009b) has proved that regular glucose level monitoring among patients with type 1 diabetes can lead to a decrease of hypoglycemic events. In addition, such trends were also associated with the previous experiences of patients. Battelino et al. (2011) came to a similar conclusion that CGT is beneficial for hypoglycemia risk reduction and is helpful for the effective diabetes symptoms treatment. Another study of the same researcher has provided evidence that only regular glucose monitoring can bring the effective and desirable results in diabetes treatment (Beck, 2009a). Therefore, it is obvious that monitoring at home is more likely to provide the precise and regular frequent daily results that the clinical monitoring in case a person is not staying at the hospital on a regular basis. Moreover, the comparison of the two groups that underwent regular clinical and self-monitoring of the glucose level has brought the researchers to the conclusion that self- monitoring is more effective due to the fact that such control is more regular, less time-consuming, and ensures frequent and precise results (Pickup, 2011).
The technological advancements have contributed considerably to the development of telemedicine. Mainly, such direction of the medical practice presents wearable sensors for diabetes as the most effective tools to monitor blood glucose, physical state, and even calculate dietary calories of patients (Appelboom et al., 2014). According to Piwek et al. (2016), the major advantage of such devices is that they provide opportunities to make decisions regarding the health and necessary treatment without visiting the hospital. They also help detect emergency cases early enough so that professionals can make the necessary interventions as soon as possible. Vashist (2012) provides evidence that frequent glucose monitoring is the basic part of diabetes management. However, he also criticizes the existing self-monitoring devices for being invasive and points out the necessity to implement the non-invasive devices that would measure glucose levels without pricking the skin regularly (Vashist, 2012). Wilson et al. (2007) studied the accuracy of the devices that are used by the patients for self-monitoring and found out that home glucose meters are not always precise in measuring the glucose levels. GlucoWatch G2 Biographer and CGMS have proven to be effective in raising the patients’ awareness and leting them regulate their regime (Wilson et al.б 2007). However, the FreeStyle Navigator monitoring system shows a large number of mistakes in work (Wilson et al.б 2007). Nevertheless, it is recommended to use such sensors at home to support the glucose level awareness. Even though the information can sometimes be less than precise, people get the information about the glucose trends and the highest or lowest thresholds. Additionally, Raccah et al. (2009) provide the empirical evidence that the glucose sensors, specifically the subcutaneous ones, ensure the precise control over type 1 diabetes risks. Due to the continuous monitoring, such sensors become particularly helpful to the patients who need to avoid or at least reduce the hypo- and hyperglycemic events. Cho et al. (2006) investigated the internet-based monitoring systems in order to prove that it is a great tool to control glucose levels and ensure their stability. In particular, the patients with type 2 diabetes were involved in the study to identify how glucose monitoring is helpful to control the disease and avoid various complications.
One of the problems is that it is not always convenient for people to measure their levels of glucose. Even though people are aware that self-monitoring of blood glucose is crucial to achieve the target glycated hemoglobin levels not all patients measure their glucose levels after meals or in the evenings (Tamborlane et al., 2008). In addition, the continuous glucose monitoring can be less than accurate. Garg et al. (2006) emphasized that the periods up to 72 h are accurate and safe. Mainly, this data can become effective in helping to reduce hypoglycemia risks. Facchinetti et al. (2010) pointed out that sensor data from wearable devices can be erroneous and lead to harm rather than help for a patient. Therefore, the devices demand additional development and analysis. Tobe et al. (2009) have also emphasized that the existing devices have some disadvantages. According to the research conducted by scholars, new tools such as Bluetooth-enabled glucose meters and blood pressure monitors should help patients transmit information to a graphical format for effective remote analysis. Holmstrom (2010) has analyzed the telehealth aspects of diabetes treatment to emphasize that computerized decisions contribute greatly to self-treatment of diabetes and simplify the life of patients.
For this secondary research, it is necessary to rely on the literature analysis and the studies conducted by the scholars to identify the most widely used sensory devices, as well as define their advantages and disadvantages. However, the comparison of clinical and home glucose control is also necessary. This is why it is necessary to integrate the external and internal research and refer to the detailed clinical cases reflecting the patient’s experiences of the regular hospital visits for glucose level control and compare them to those of the patients who could use the wearable sensors and do this procedure at home. The volunteers will be found on the Internet and interviewed. The information will be confidential, and the real names of the patients will not be used. Relying on the patient’s experiences, the state of their health, the accuracy of the data, and the feedbacks of the family, the research will show the best and the worst ways to control the state of patients’ diabetics.
The wider usage of the devices and their appropriate choice has to rely on the sufficient professional recommendations and high level of patient responsibility. Therefore, it is highly recommended to provide detailed instructions to the patients and raise their awareness of the advantages of glucose-monitoring devices. Self-monitoring of glucose levels will lead to a higher demand of telehealth professionals who should provide detailed instructions to the patients and additional training to the hospital staff, whose awareness regarding the most appropriate devices for the self-control of glucose level must be raised. Overall, it is important to realize that self-control is not absolutely reliable and the inattentiveness or obliviousness can lead to some failures in the monitoring system. Even though it is necessary to encourage diabetics to monitor their blood glucose levels and learn to manage their symptoms, it is still necessary to ensure the prompt support of the telenurses who should ensure the timely reaction to unpredicted problems with the device or any issues predetermined by the human factor.
The implications of the research findings to the nursing practice are appropriate for both primary care settings and remote consultations. By talking to the patients and their relatives, nursing stuff should contribute to people’s awareness of the availability of healthcare monitoring and the knowledge of the signals of emergency cases. Overall, introduction of the widely used self-monitoring of the glucose level is an effective way to lessen the nurses’ workload at the hospitals and ensure better levels of life satisfaction and lower levels of complications among the patients with diabetes. Although the devices need improvements, they are an effective solution to decrease the hypo- and hyperglycemic events among the diabetics.