Summary: In 198 community-dwelling adults aged 65 years and older with type 2 diabetes, a 6-month home telemedicine intervention combined with Health Belief Model education produced a between-group HbA1c reduction of 0.42% (95% CI 0.12% to 0.73%) versus a conventional management programme. Self-management, self-efficacy, and health-belief scores also improved, though the trial was single-centre and unblinded.
PICO Summary
| Element | Detail |
|---|---|
| Population | 198 community-dwelling adults aged 65 years and older with type 2 diabetes; single-centre randomised controlled trial, China; 191/198 (96.5%) completed. |
| Intervention | Home telemedicine with health education based on the Health Belief Model over 6 months (n=99). |
| Comparison | Conventional diabetes management programme, usual care (n=99). |
| Outcome | Primary HbA1c: intervention -0.99% (95% CI -1.60% to -0.60%), control -0.42% (95% CI -0.90% to 0.90%); between-group difference 0.42% greater reduction (95% CI 0.12% to 0.73%), statistically significant. Secondary at 3 and 6 months versus control: self-management skills mean 5.88 (95% CI 4.98 to 6.79), self-efficacy mean 9.40 (95% CI 8.15 to 10.66), health beliefs mean 19.54 (95% CI 17.71 to 21.36). No p-values or ARR/NNT reported; the primary outcome is continuous. |
Home telemedicine + Health Belief Model education
RCT · older adults · type 2 diabetes · 6 months
Home telemedicine with Health Belief Model education cut HbA1c by 0.42% more than conventional care over 6 months in older adults with type 2 diabetes, a modest but statistically significant gain. Single-centre and unblinded, so confirmation is needed.
Expert Commentary
This single-centre randomised controlled trial reports a statistically significant between-group HbA1c reduction of 0.42% (95% CI 0.12% to 0.73%) favouring home telemedicine combined with Health Belief Model education over a conventional management programme in older adults with type 2 diabetes. The verdict is cautiously positive: a clinically modest but real glycaemic signal was accompanied by consistent gains in self-management, self-efficacy, and health-belief measures, and retention was excellent at 96.5%. The principal limitation is design, because a behavioural intervention of this kind cannot be blinded; participants and educators knew their allocation, and the self-reported secondary outcomes are therefore vulnerable to expectation effects. Generalisability is further constrained by recruitment from a single community setting in one country and a 6-month horizon that leaves durability untested. No industry or manufacturer sponsorship was evident, and the effect sizes are plausible rather than implausibly large. Can I use this with my patients? Tentatively, yes, for motivated older adults who have home connectivity and benefit from structured education and remote contact, as an adjunct rather than a replacement for established care. Larger multi-centre trials with longer follow-up and objective endpoints are needed before this model is recommended for routine adoption.
References
Zhang A, Wang J, Wan X, Zhang Z, Zhao S, Bai S, et al. Community-based intelligent blood glucose management for older adults with type 2 diabetes based on the Health Belief Model: randomized controlled trial. JMIR Mhealth Uhealth. 2025;13:e60227. doi:10.2196/60227