Townsville Diabetes Home Monitoring Project

INTERVENTION: The intervention is 12 months in duration. Using NBN telehealth technologies patients will receive online diabetes care from a doiabetes educator nurse (DEN) via an in‐home broadband monitoring and communication device that can prompt the capture of clinical measures including: regular blood pressure monitoring (at least once a week depending on patient); regular blood glucose monitoring (at least once a week depending on patient) ; 6 monthly participation in monitored online health questionnaires to reinforce diabetes self management and assist early detection of complications; participation in clinical video conferencing sessions as required with diabetes educator nurse and GP (on a case by case basis). CONDITION: Type II diabetes PRIMARY OUTCOME: With 210 completing participants (105 in each arm) we will be able to detect intervention effects over usual care effects of at least a 0.4% reduction in HbA1c. This will be assessed by measuring HbA1c from patients' blood analysis. SECONDARY OUTCOME: Improved biomedical outcome (Renal function) which will be assessed by measuring serum creatine/eGFR via analysis of patients' blood Improved biomedical outcomes (Cholesterol) which will be assessed by blood analysis of patients' cholesterol levels Improved biomedical outcomes (Weight and waist circumference). Patients' weight and waist circumference will be assesed via clinical assessment. Improved biomedical outcomes (blood pressure‐systolic and diastolic) which will be assessed via patients' blood pressure meaurement using a blood pressure monitor Improved experience of care derived from questionnaires administered to both patients and care providers Improved service utilisation and efficiency of healthcare workforce assessed via data on health care utilisation by patients for primary care services and admissions to public hospitals. The intervention arm will also incur the costs of intervention including set up (home monitors) and operating costs (diabetes educator nurse) Incidence of diabetes related complications (derived from clinical record audit data) Quality of life measures (quality of life questionnaire; Patient assessment of chronic illness care questionnaire; clinical depression and mental health questionnaire) Utilisation of technology derived from questionnaires administerd to intervention patients and care givers INCLUSION CRITERIA: For a patient to be included in the trial: Have a regular GP providing primary care The practice should have a diabetes register (using Canning data extractor tool or equivalent) Patients should: Be diagnosed with type 2 Diabetes (not type 1) Live in a National Broadband Network (NBN) connected area in their home (not a residential aged care facility) & be willing to connect to NBN at no cost Be an adult, aged 18 years or over Have recorded a HbA1c greater than or equal to 7.5 % at any time in the previous 12 months (or if no result available, HbA1c greater than or equal to 7.5 % when tested)