Background: Despite substantial investment in detection, early intervention and evidence-based treatments, current management strategies for diabetes-associated retinopathy and CVD are largely based on real-time and face-to-face approaches. There are limited data re telehealth facilitation in type 2 diabetes management. Therefore, we aim to investigate efficacy of telehealth facilitation of diabetes and CVD care in high-risk vulnerable Aboriginal and Torres Strait Islanders in remote/very remote Australia.
Methods/Design: Using a pre-post intervention design, 600 Indigenous Australians with type 2 diabetes will be recruited from three primary care health services in the Northern Territory. Diabetes status will be based on clinical records. There will be four technological interventions: 1. Baseline retinal imaging [as a real-time patient education/engagement tool and telehealth screening strategy]. 2. A lifestyle survey tool administered at ≈6-months. 3. At ≈6- and 18-months, an electronic CVD and diabetes decision-support tool based on guidelines in the Standard Treatment Manual [5th edition] of the Central Australian Rural Practitioner’s Association to generate clinical recommendations. 4. Mobile tablet technology developed to enhance participant engagement in self-management. Data will include: Pre-intervention clinical and encounter-history data, baseline retinopathy status, decision-support and survey data/ opportunistic mobile tablet encounter data. The primary outcome is increased participant adherence to clinical appointments, a marker of engagement and self-management. A cost-benefit analysis will be performed.
Conclusion: Telehealth could facilitate evidence-based management of diabetes in Indigenous Australians and serve as a model for other conditions. Australia and New Zealand Clinical Trials Register number (ANZCTRN): 12616000370404