Clinical Efficacy of a Telemedicine Program for Lifestyle Modification Involving Self-monitoring of Health Status, and Patient Compliance with It
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概要
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Objective: To change lifestyle behavior in the treatment of hypertension, diabetes, dyslipidemia and obesity, we tested a telemonitoring system (i-TECHO) consisting of an automated sphygmomanometer, a body weighing scale and a pedometer. These devices were connected via USB to a specific home gateway device, which transmitted self-monitoring data to a central server via the cellular-phone network. Methods: One hundred and two patients with lifestyle diseases (average age 51.5, 84 males and 18 females) were asked to measure their blood pressure every morning and before going to bed at night, and body weight every morning, and to wear a pedometer all the time except when they were in bed for 3 to 4 months. Charts made from the telemonitoring data were sent to each patient by mail each month. Results: The averages of blood pressure, body weight and daily steps and all other measurements, significantly improved, especially in the subjects with an initially poor lifestyle status. The actual measurements as a proportion of the total number due were 55-76% for each sensor and the rates decreased significantly in the third month. Only 5-12% of the subjects complained that they could not conduct the self-measurement well but a considerable proportion of them (32.5%) found difficulty in the data transmission procedure. Elderly people showed greater willingness to pay for a potential commercial health promotion service using i-TECHO.Conclusions: Although the usefulness of the i-TECHO system in achieving lifestyle changes was validated, it should be made easier to use by revisions such as adopting automatic wireless data transmission, and encouragement through the provision of individualized advice should also be given.
著者
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Satoki Homma
School of Medicine, Keio University, Dept. Medical Environmental Informatics Science
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Masayoshi Sone
Sone Clinic
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Iwao Kurose
Kei-ai Clinic
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Ryoko Homma
Jiyugaoka Homma Clinic
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Takeo Nagare
Omron Healthcare Co. Ltd.