Short summary

The number of outpatient visits at the Department of Endocrinology of Odense University Hospital is expected to rise significantly over the coming years (from approximately 45,000/y in 2013 to 60,000/y in 2020) and therefore it becomes a challenge to accommodate this increasing activity.

As the citizens have greater access to IT technology, such as computers, smart phones and tablets, there is a new and growing focus on communication via these channels. Our goal is to give patients a better life for less money through the introduction of a virtual outpatient clinic, mainly based on video consultations instead of attendance.

When the present study has been carried out, we expect to be able to convert around 20,000 face-to-face consultations to virtual consultations per year.

Rationale

The general hypothesis behind this clinical trial is founded on the following facts:

• The number of patients with diabetes is expected to grow over the coming years and therefore the management of the disease in the current set-up will not be able to meet the future needs.
• Citizens have gained access to IT technology, such as computers, smart phones and tablets, over the past years and there is a growing focus on communication via these kind of technologies.
• The use of telemedicine (phone, mails, videoconsultations etc.) for disease management or education often results in an increase in patient's satisfaction, which is an important quality indicator.
• Diabetes is well suited for being treated with telemedicine, especially when monitoring occurs, since many types of inputs can be digitalized through e-journal such as the results of the biochemical tests.
• The use of telemedicine and/or app-based solutions for the management of diabetes has been shown to increase self-consciousness/empowerment and compliance.

We hypothesize that:

A patient- driven, telemedicine supported, approach to the treatment of diabetes in an outpatient clinic will improve patient satisfaction and compliance. Our novel approach for the control and treatment of diabetes includes one face-to-face consultation and one videoconsultation with an interval of 12 months and telemedical support, if needed by the patient, during the 12-month interval.

Moreover we hypothesize that this new setup for the outpatient clinic will deliver a health service of at least comparable quality (non-inferiority) to the conventional care and achieve comparable or improved clinical outcomes.

Also, we hypothesize that this individual-centered approach has the potential to improve the cost-benefit of diabetes control and treatment.

Description of the cohort

All diabetic patients - type 1, type 2 and other diabetes types - attending the outpatient clinic at the dept. of Endocrinology at Odense University Hospital. 

Data and biological material

We aim to assess the effect of the patient-driven, telemedicine supported approach for the control and treatment of diabetes, compared to the conventional approach, on the incidence of the following endpoints:

• Glycaemic control (HbA1c)
• Problem areas in Diabetes (questionnaire)
• Patient satisfaction (indicator of the quality of the health service)
• Health professionals telemedicine satisfaction 
• Compliance to scheduled blood testing
• Number of contacts with the patients (face-to-face, virtual, telephone)

Collaborating researchers and departments

The Research Unit of User Perspectives of the department of Public Health, University of Southern Denmark

OPEN Odense Patient data Explorative Network, Institute of Clinical Research, University of Southern Denmark