Grant: Oper Grant:eHealth Innov Partnership Program(eHIPP)-Seniors w Complex Care Needs

Diabetes affects over 20% of Canadians over the age of 65y. Seniors with diabetes are at high risk for cardiovascular disease and death. Most of this risk is mediated through high blood pressure (BP). However, seniors are also at risk for side effects from BP lowering medication. These can be life threatening and costly. Therefore, BP monitoring is required to ensure BP levels are in the recommended range (neither too high nor low). Home BP monitoring can be used to ensure that BP is in the right range and is recommended for all patients with high BP. Studies in other health care systems show that, to optimally perform home monitoring, the readings should be teletransmitted (electronically sent to the care provider). Additional studies indicate that BP control improves when health care providers (usually pharmacists or nurses) are specifically assigned to review teletransmitted BP readings and, using protocols, make therapeutic adjustments. However, a study needs to be conducted within the Canadian healthcare system to prove that telemonitoring works here, that case management provides incremental benefit, and that telemonitoring±case management is cost-effective. In addition, we need to prove that seniors consider telemonitoring to be usable and acceptable. We will conduct a 300 patient randomized trial in community-dwelling seniors, that will compare usual care, to telemonitoring alone, to telemonitoring plus case management. We will comprehensively assess cost-effectiveness, useability, and acceptability. Our partners include TeleMED, a medium sized Canadian technology company with a wealth of experience in medical data management and transmission; Pharmacare, which will provide case-management services; and Greater Edmonton Foundation and Rosedale seniors' residences. This intervention, if effective, cost-effective and safe, can be widely implemented and has very high commercialization potential to be commercialized and widely implemented.