This study evaluates a complex telemedicine-based intervention targeting patients with chronic health problems. Computer tablets and home telemonitoring devices are used by patients to report point-of-care measurements, e.g., blood pressure, blood glucose or oxygen saturation, and to answer health-related questions at a follow-up center. We designed a pragmatic randomized controlled trial to compare the telemedicine-based intervention with usual care in six local centers in Norway. The study outcomes included health-related quality of life (HRQoL) based on the EuroQol questionnaire (EQ-5D-5L), patient experiences, and utilization of healthcare. We also conducted a cost–benefit analysis to inform policy implementation, as well as a process evaluation (reported elsewhere). We used mixed methods to analyze data collected during the trial (health data, survey data and interviews with patients and health personnel) as well as data from national health registers. 735 patients were included during the period from February 2019 to June 2020. One year after inclusion, the effects on the use of healthcare services were mixed. The proportion of patients receiving home-based care services declined, but the number of GP contacts increased in the intervention group compared to the control group. Participants in the intervention group experienced improved HRQoL compared to the control group and were more satisfied with the follow-up of their health. The cost–benefit of the intervention depends largely on the design of the service and the value society places on improved safety and self-efficacy.

这项研究评估了针对患有慢性健康问题的患者的复杂的远程医疗干预措施。患者使用平板电脑和家庭远程监控设备报告即时测量结果，例如血压、血糖或血氧饱和度，并在随访中心回答与健康相关的问题。我们设计了一项务实的随机对照试验，在挪威的六个当地中心将基于远程医疗的干预措施与常规护理进行比较。研究结果包括基于 EuroQol 问卷 (EQ-5D-5L) 的健康相关生活质量 (HRQoL)、患者体验和医疗保健利用。我们还进行了成本效益分析，为政策实施提供信息，并进行了流程评估（在其他地方报告过）。我们使用混合方法来分析试验期间收集的数据（健康数据、调查数据以及对患者和卫生人员的访谈）以及来自国家健康登记册的数据。2019 年 2 月至 2020 年 6 月期间纳入了 735 名患者。纳入一年后，对医疗服务使用的影响参差不齐。与对照组相比，干预组接受家庭护理服务的患者比例有所下降，但全科医生接触的数量有所增加。与对照组相比，干预组的参与者的 HRQoL 有所改善，并且对其健康状况的随访更加满意。干预措施的成本效益在很大程度上取决于服务的设计以及社会对提高安全性和自我效能的重视。