The Pacific Medical Research Foundation has a history of being involved in important research related to diabetes treatment and education. Here are just of few of our past projects.
Smart MODM
Digital Retinopathy Screening
Diabetes Management on the Internet
The Smart MODM Project (MODM stands for Management Online of Diabetes Melitus) was a clinical trial supported by Smart Valley, Inc., The Pacific Medical Research Foundation, Endocrine Metabolic Medical Center, and Caresoft, Inc. It was a three phase trial designed to investigate the effects of online interactivity between diabetic patients and caregivers.
Endocrine Metabolic Medical Center (EMMC) is a healthcare facility in Redwood City, California, dedicated to the education and improved health of the person with diabetes. EMMC has modeled it's practice around the findings of the Diabetes Control and Complications Trial, released in 1993, a study that showed that any improvement in blood glucose control reduced the risk of complication development. EMMC has isolated a number of patients who are having difficulty maintaining their blood glucose within a desired range, and has separated this group into those who are connected to the internet and those who are not.
Caresoft, Inc. was a software company in Mountain View, California. Caresoft has developed "Condition Management" software that enables a caregiver at a clinic setting to take a more proactive approach in their diabetic patients' care using the internet as the mode of communication. This software in conjuction with the quality care at EMMC were the key ingredients to this clinical trial.
ABSTRACT BY: JOSEPH PRENDERGAST, CYNTHIA DORSEY, PENELOPE MAYES
Digital retinal photography in the non-pharmacologically dilated eye was used in 28 patients for annual retinopathy screening. The images were printed immediately from the computer then electronically forwarded to a central area and graded by trained photographic readers using the modified Airlie House Protocol as used for the Early Treatment Diabetes Retinopathy Study (ETDS). Results were returned electronically for clinical review as summarized. A retinal expert was available by telephone (Ophthalmic Imaging Systems) if discussion was desired.
No retinopathy 21%
Questionable retinopathy 4%
Microaneurysms only 29%
Non-proliferative 25%
Proliferative 4%
Cannot evaluate 18%
18% were inadequate for evaluation due to cataracts, small pupils and operator difficulties. The data is archived and accessible for sequential comparison or transfer directly to another licensed treating eye professional. This system can easily be incorporated in annual visits since it only takes seconds to photograph each eye. All information can be sent any distance, thus increasing access and decreasing costs. This process has potential for increasing the quality of care to the underserved.
Diabetes Management on the Internet
ABSTRACT BY: JOSEPH PRENDERGAST, CYNTHIA DORSEY, MICHELLE PERROT
The DCCT addressed patient compliance difficulties in part with frequent telephone contacts and office visits. We have evaluated a specific diabetic Internet protocol (Caresoft) as a new method to increase the intensity of interaction and expand patient education.
Eight type II patients treated with insulin had HbA1c above 8% despite a year of maximum oral agents, education and insulin. Phone calls were made on a 2 to 6 week basis to improve control and visits as decided by the case manager and supervising physician. Four continued this regime and four were placed on the Internet diabetes management system.
The Internet group had a personal patient identifier to enable the security of the system to provide a personal, private journal of care reviewed daily by the case manager. Education in terms of problem solving was given by the case manager and an online library was offered as well. Interactive personal and group message boards were the only communications over 8 weeks. No patient in either group had any emergency necessitating telephone calls or office visits. Glucose measurements were sent regularly via cable interface (Precision QID, MediSense) to the Internet site and reviewed by the case manager. Treatment changes were made through the Email component.
At 2 months, the Internet protocol patients had decreased HbA1c .7% on an average and the control group had increased by .6%. This small study suggests that an Internet protocol can give a higher intensity of diabetic treatment which might help compliance in difficult patients.