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Questions Raised for Telemedical Monitoring of Diabetic Foot Ulcers

No significant difference versus standard care for amputation, healing; but increase in mortality seen

MONDAY, July 6, 2015 (HealthDay News) — Telemedicine monitoring is not associated with any significant difference in amputation or healing, but may be linked to increased mortality for patients with diabetic foot ulcers, according to a study published online June 26 in Diabetes Care.

Benjamin S.B. Rasmussen, from the Odense University Hospital in Denmark, and colleagues compared telemedicine and standard outpatient monitoring in the care of patients with diabetic foot ulcers. One hundred ninety-three patients were randomly allocated to telemedical monitoring, which consisted of two consultations in the patient’s home and one in the outpatient clinic; 181 patients were randomized to standardized care, which included three outpatient clinic visits.

The researchers observed no difference with respect to wound healing (hazard ratio [HR], 1.11; 95 percent confidence interval [CI], 0.87 to 1.42; P = 0.42) or amputation (HR, 0.87; 95 percent CI, 0.54 to 1.42; P = 0.59) for individuals monitored through telemedicine or standard care. The incidence of mortality was higher in the telemedicine versus the standard care group (HR, 8.98; 95 percent CI, 6.93 to 10.88; P = 0.0001).

“The findings of no significant difference regarding amputation and healing seem promising; however, for telemedical monitoring, a higher mortality throws into question the role of telemedicine in monitoring diabetic foot ulcers,” the authors write.

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