Experience with Obese Patients Followed via Telemedicine in a Latin American Tertiary Care Medical Center
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design and Context
2.2. Overview of the “Siempre” Teleconsultation Program
2.3. Population and Sample Size
2.4. Variables
2.5. Statistical Analysis
3. Results
4. Discussion
4.1. Principal Findings
4.2. Results in Context
4.3. Limitations and Strengths
4.4. Future Implications
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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First-Time Group (FG), n = 88 | Follow-Up Group (FUG), n = 114 | |
---|---|---|
Number of teleconsultations * | 3 (2–5) | 3 (2–4) |
Age, years * | 39 (32–45) | 41 (33–52) |
Health Insurance%) | ||
Contributive | 11 (12.5) | 11 (9.6) |
Prepaid | 71 (80.6) | 101 (88.5) |
Particular | 6 (6.81) | 2 (1.71) |
Residence (%) | ||
Urban | 80 (90.9) | 111 (97.3) |
Rural | 5 (5.6) | - |
ND | 3 (3.4) | 3 (2.6) |
Occupation (%) | ||
Unemployed | 3 (3.4) | 4 (3.5) |
Employee | 55 (62.5) | 67 (58.7) |
Independent | 6 (3.4) | 7 (6.1) |
Home | 3 (3.4) | 6 (5.2) |
ND | 21 (23.8) | 30 (26.3) |
School grade | ||
High school | 1 (1.1) | 2 (1.7) |
College | 4 (4.5) | 9 (7.8) |
Postgraduate | 43 (48.8) | 63 (55.2) |
Analphabet | 10 (11.3) | 5 (4.3) |
ND | 30 (34.0) | 35 (30.7) |
Comorbidities (%) | ||
No | 30 (34.0) | 31 (27.1) |
Hypertension | 8 (9.0) | 20 (17.5) |
Diabetes | 2 (2.2) | 6 (5.2) |
Dyslipidemia | 10 (11.3) | 15 (13.1) |
Coronary artery disease | - | 1 (0.8) |
Thyroid disease | 14 (15.9) | 15 (13.1) |
Fatty liver | 4 (4.5) | 10 (8.7) |
Physical activity at first teleconsultation (%) | ||
No | 50 (56.8) | 36 (31.5) |
Yes | 23 (26.1) | 57 (5) |
ND | 15 (17.0) | 21 (18.4) |
Healthy diet at first teleconsultation (%) | ||
No | 64 (72.7) | 47 (41.2) |
Yes | 7 (7.9) | 49 (42.9) |
SD | 17 (19.3) | 18 (15.7) |
First-Time Group (FG) n = 88 | Follow-Up Group (FUG) n = 114 | |
---|---|---|
Weight, kg * | 82 (73–92) | 80.2 (71.25–97) |
BMI, kg/m2 * | 30.3 (27.5–33.7) | 30.4 (26.55–33.5) |
ABCD stage (%) | ||
stage 0 | 43 (48.8) | 36 (31.5) |
stage 1 | 44 (50) | 72 (63.1) |
stage 2 | 1 (1.13) | 6 (5.26) |
Percentage of body fat by DEXA | 44 (40.4–49) | 46.6 (45–48.5) |
Total fat weight by DEXA, kg | 38 (32–42.5) | 34.5 (31.1–37.95) |
Android fat/gynoid fat ratio by DEXA | 1.025 (0.8–1.1) | 0.96 (0.9–1) |
Fasting blood glucose (mg/dL) | 91.6 (84–98) | 91 (85.5–100) |
LDL colesterol (mg/dL) | 115.25 (97.3–131.5) | 117 (97–139) |
HDL colesterol (mg/dL) | 48.9 (42–57.9) | 46 (40–57) |
Triglycerides (mg/dL) | 134 (90–198) | 121 (88–166) |
Creatinine (mg/dL) | 0.76 (0.6–0.8) | 0.78 (0.68–0.8) |
Ferritin (ng/mL) | 92.5 (45–185.5) | 94.9 (44.9–222) |
Glycosylated hemoglobin (%) | 5.4 (5.2–5.6) | 5.4 (5.2–5.6) |
Uric acid (mg/dL) | 4.65 (3.9–6) | 4.55 (3.7–5.8) |
Testosterone (only for men) (ng/mL) | 4 (3.98–5.3) | 4.5 (3.9–17) |
First-Time Group (FG), n = 88 | Follow-Up Group (FUG), n = 114 | |
---|---|---|
Weight (kg) | ||
Value at 3 months | 75 (67.1–81.7) | 73.8 (66–88) |
Value at 6 months | 72.5 (63–81) | 70.5 (60–83) |
BMI (kg/m2) | ||
Value at 3 months | 27.9 (26.1–30.9) | 28 (25.6–31.2) |
Value at 6 months | 26.6 (24.8–30.3) | 26.35 (24.2–29.2) |
Fasting blood glucose (mg/dL) | ||
Value at 3 months | 91.7 (89–105) | 90 (83.5–95) |
Value at 6 months | 92 (86–98.5) | 89.5 (86–91) |
LDL cholesterol (mg/dL) | ||
Value at 3 months | 96 (73–127) | 106 (83–134.3) |
Value at 6 months | 99.5 (79–116) | 118 (64–135) |
HDL cholesterol (mg/dL) | ||
Value at 3 months | 53 (46–62) | 49 (43.25–57.5) |
Value at 6 months | 45 (41–49) | 51 (42.1–72) |
Triglycerides (mg/dL) | ||
Value at 3 months | 92 (88–130) | 119 (93–146) |
Value at 6 months | 142.5 (109–164) | 97 (86–145) |
Creatinine (mg/dL) | ||
Value at 3 months | 0.815 (0.7–0.9) | 0.8 (0.71–0.9) |
Value at 6 months | 0.77 (0.7–0.9) | 0.8 (0.6–0.8) |
Ferritin (ng/mL) | ||
Value at 3 months | 66 (31–133) | 130 (79–249) |
Value at 6 months | 204 (30.9–625) | 175 (12–268) |
Glycosylated hemoglobin (%) | ||
Value at 3 months | 5.4 (5.2–5.8) | 5.42 (5.1–5.5) |
Value at 6 months | 5.4 (5.37–5.5) | 5.4 (5.2–5.6) |
Uric acid (mg/dL) | ||
Value at 3 months | 3.9 (3.6–4.8) | 3.62 (3.38–4.2) |
Value at 6 months | 4.2 (4.1–4.8) | 4.3 (3.56–4.6) |
Testosterone (only for men) (ng/mL) | ||
Value at 3 months | 4.75 (4.75–4.75) | 6.735 (3.07–10.4) |
Value at 6 months | - | 4.11 (4.11–4.11) |
Percentage of body fat by DEXA evaluated at last teleconsultation (%) | 41.25 (37–47) | 48 (45–51) |
Total fat weight by DEXA evaluated at last teleconsultation, kg | 32 (26–34.3) | 42.85 (36–49.7) |
Android fat/gynoid fat ratio by DEXA at last teleconsultation | 0.965 (0.92–1.06) | 0.96 (0.91–1.01) |
Physical activity at last teleconsultation (%) | ||
No | 14 | 10 |
Yes | 42 | 58 |
ND | 32 | 46 |
Healthy diet at last teleconsultation (%) | ||
No | 9 | 9 |
Yes | 46 | 63 |
ND | 33 | 42 |
Time 0, n = 78 | Time 1, n = 63 | Time 2, n = 36 | p Value | |
---|---|---|---|---|
General weight, kg | 84.0 (73.0–97.0) | 78.0 (68.0–90.0) | 75.0 (68.0–88.0) | <0.001 |
Age, years | ||||
18–26 | 82.0 (67.0–93.0) | 73.0 (62.0–82.0) | 78.5 (67.5–98.5) | <0.001 |
27–59 | 84.0 (73.0–96.0) | 78.5 (69.0–90.0) | 73.0 (68.5–84.5) | <0.001 |
≥60 | 98.5 (84–103) | 99.5 (89–102) | 101 (55–104) | >0.99 |
Type of teleconsultation | ||||
First time | 83.0 (73.0–90.0) | 78.0 (68.0–85.0) | 71.5 (63.5–83.0) | <0.001 |
Control | 89.0 (73.0–101.0) | 82.5 (68.0–100.0) | 82.0 (73.0–99.0) | <0.001 |
Number of teleconsultations | ||||
2–3 | 84.0 (73.0–102.0) | 79.0 (68.0–100.0) | 79.0 (69.0–94.0) | <0.001 |
4–5 | 84.0 (73.0–91.0) | 75.0 (71.0–87.0) | 72.0 (63.0–82.0) | <0.001 |
≥6 | 84.0 (73.0–97.0) | 79.0 (67.5–91.5) | 81.5 (69.0–88.0) | <0.001 |
ABCD stage | ||||
0 | 75.0 (66.0–85.0) | 69.0 (62.0–76.0) | 69.5 (63.0–80.0) | <0.001 |
1 | 90.0 (80.0–102.0) | 84.0 (76.0–98.0) | 81.0 (73.0–94.0) | <0.001 |
2 | 104.0 (101.0–122.0) | 103.0 (100.0–117.0) | 93.0 (68.5–112.0) | 0.215 |
Factor | Adjusted Weight Change | p Value |
---|---|---|
Time | ||
Time 0 | - | |
Time 1 | −4.1 (−5.1–−3.1) | <0.001 |
Time 2 | −8.6 (−10–−7.3) | <0.001 |
ABCD stage | ||
0 | - | |
1 | 15.6 (10.1–21.1) | <0.001 |
2 | 28.2 (15.7–40.8) | <0.001 |
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López, A.; Escobar, M.F.; Urbano, A.; Alarcón, J.; Libreros-Peña, L.; Martinez-Ruiz, D.M.; Casas, L.Á. Experience with Obese Patients Followed via Telemedicine in a Latin American Tertiary Care Medical Center. Int. J. Environ. Res. Public Health 2022, 19, 12406. https://doi.org/10.3390/ijerph191912406
López A, Escobar MF, Urbano A, Alarcón J, Libreros-Peña L, Martinez-Ruiz DM, Casas LÁ. Experience with Obese Patients Followed via Telemedicine in a Latin American Tertiary Care Medical Center. International Journal of Environmental Research and Public Health. 2022; 19(19):12406. https://doi.org/10.3390/ijerph191912406
Chicago/Turabian StyleLópez, Alejandro, Maria Fernanda Escobar, Alejandra Urbano, Juliana Alarcón, Laura Libreros-Peña, Diana Marcela Martinez-Ruiz, and Luz Ángela Casas. 2022. "Experience with Obese Patients Followed via Telemedicine in a Latin American Tertiary Care Medical Center" International Journal of Environmental Research and Public Health 19, no. 19: 12406. https://doi.org/10.3390/ijerph191912406