How effective is an interactive Internet-based platform for managing chronic diseases at a distance?

An older women sits at home and helps take her partner's blood pressure during a remote call to a health specialist

Data access has been approved for a study to evaluate the Internet-based Chronic Disease Management (iCDM) project, a multi-chronic disease management program delivered though the Internet with telephone supports. The iCDM targets patients with multiple high-impact chronic diseases living in rural communities.

In 2005, more than one-third of Canadians suffered from one or more chronic diseases. Between 2005 and 2015, it is estimated that two million Canadians will have died of causes related to a chronic disease at a cost of more than $9 billion of national income. These trends are likely to continue over the next 30 years, as the proportion of people aged over 65 years will be greater than that of other age groups in Canada, and the prevalence of chronic diseases is expected to rise in parallel.

Patients with one chronic disease often have, or are at risk for, another chronic disease. For example, diabetes and chronic kidney disease are risk factors for ischemic heart disease, and many patients with ischemic heart disease will face a future diagnosis of heart failure. This group of complex patients represents a substantial challenge to healthcare resources; as compared to patients with only one chronic disease, these patients present with a greater number of primary care and specialist visits, acute care hospital days, and redundant duplicate laboratory tests.

“For patients in rural communities, the opportunity to attend ambulatory care clinics is not always an option, or only at substantial cost to the patient with respect to time and travel to urban centres,” according to project lead Dr. Scott Lear, of the Healthy Heart Program at St Paul’s Hospital, and Professor, Faculty of Health Sciences at Simon Fraser University. “The opportunity for rural patients to receive quality care close to, or within their homes, is of great benefit as it reduces the need for extensive travel and the potential burden of clinic visits. The use of telehealth has been identified as an effective modality for chronic disease management and is actively promoted by national organizations as having great promise for health service delivery in rural areas.”

Information gained from this study will provide evidence as to whether the iCDM is an effective intervention to help remotely patient self-management and monitoring of patient symptoms. The hypothesis is that patients with multiple chronic diseases utilizing a chronic disease management program delivered through the Internet (with telephone supports) will have lower hospital admissions over a two-year period compared to patients utilizing usual care only.

The study is funded by the Canadian Institutes of Health Research and the Michael Smith Health Research BC (formerly The Michael Smith Foundation for Health Research).

PopData will link Researcher-collected data with four data sets from the BC Ministry of Health for the project.