Cargando…
SUN-678 Telediabetes Improves A1C and Patient Satisfaction: A Pilot Study in a VA Institution
Introduction: Rural Americans experience significant health disparities and have poorer health outcomes compared to their urban counterparts. Access to health care services in rural areas remains an ongoing challenge. Telehealth services can efficiently and effectively improve access to healthcare f...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7207731/ http://dx.doi.org/10.1210/jendso/bvaa046.1955 |
_version_ | 1783530673846353920 |
---|---|
author | Behari, Gauri Vinales, Karyne Lima Correa, Ricardo Rafael Reaven, Peter Harman, Sherman Mitchell |
author_facet | Behari, Gauri Vinales, Karyne Lima Correa, Ricardo Rafael Reaven, Peter Harman, Sherman Mitchell |
author_sort | Behari, Gauri |
collection | PubMed |
description | Introduction: Rural Americans experience significant health disparities and have poorer health outcomes compared to their urban counterparts. Access to health care services in rural areas remains an ongoing challenge. Telehealth services can efficiently and effectively improve access to healthcare for people living in rural and remote areas. However, it is unclear if telemedicine services would be effective in the veteran population. Therefore, we have initiated a pilot studyto verify the effectiveness and satisfaction of diabetes care delivered through telehealth (Telediabetes) in a Phoenix VA community-based outpatient clinic (CBOC). Methods: The Southeast CBOC is a remote VA clinic in Phoenix with the largest volume of patients with diabetes. Inclusion criteria were patients with type 2 diabetes that have been seen at least one time in the endocrinology clinic at the Phoenix VA and were willing toparticipate in telemedicine. Of the 36 patients that qualified for the study, 20 (55%) were scheduled, 11 (31%) were unreached, and only 5 (14 %) declined. Interventions included optimizing use of newer diabetes medications such as GLP-1 agonists and SGLT2 inhibitors andefforts to improve adherence to treatment regimens. Methods to improve adherence included offering home self-monitoring of blood glucose, increased frequency of visits, including home video conferencing and recommending referrals to nutrition and clinical pharmacists for amultidisciplinary approach. Patient satisfaction was assessed through a validated 5-question survey using a Likert scale 1-5 immediately after each visit. The primary outcomes were change in A1c and patient satisfaction. Results: 95% (17/18) of the participants were males, the mean age was 62.5±.14.0 years-old, and the mean BMI was 34.4±6.8 kg/m(2). Median follow-up time was 189 days (range: 89-417). During follow-up, A1c decreased by 0.8% (baseline: 9.5±2.2 vs. post-visit: 8.7±2.0%, p=0.017).Overall, all patients were fully satisfied (Likert score of 5) with the telediabetes visits and 94% of the patients would choose telehealth over face-to-face appointments. Up to now 37% of patients have had at least a second visit with telediabetes. Conclusion: Telediabetes is an effective alternative to face-to-face visits for rural veterans, as demonstrated in other communities. The high patient satisfaction and decrease in A1c in this study showed that the program can be expanded to increase access to diabetes care in remoteareas. |
format | Online Article Text |
id | pubmed-7207731 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-72077312020-05-13 SUN-678 Telediabetes Improves A1C and Patient Satisfaction: A Pilot Study in a VA Institution Behari, Gauri Vinales, Karyne Lima Correa, Ricardo Rafael Reaven, Peter Harman, Sherman Mitchell J Endocr Soc Diabetes Mellitus and Glucose Metabolism Introduction: Rural Americans experience significant health disparities and have poorer health outcomes compared to their urban counterparts. Access to health care services in rural areas remains an ongoing challenge. Telehealth services can efficiently and effectively improve access to healthcare for people living in rural and remote areas. However, it is unclear if telemedicine services would be effective in the veteran population. Therefore, we have initiated a pilot studyto verify the effectiveness and satisfaction of diabetes care delivered through telehealth (Telediabetes) in a Phoenix VA community-based outpatient clinic (CBOC). Methods: The Southeast CBOC is a remote VA clinic in Phoenix with the largest volume of patients with diabetes. Inclusion criteria were patients with type 2 diabetes that have been seen at least one time in the endocrinology clinic at the Phoenix VA and were willing toparticipate in telemedicine. Of the 36 patients that qualified for the study, 20 (55%) were scheduled, 11 (31%) were unreached, and only 5 (14 %) declined. Interventions included optimizing use of newer diabetes medications such as GLP-1 agonists and SGLT2 inhibitors andefforts to improve adherence to treatment regimens. Methods to improve adherence included offering home self-monitoring of blood glucose, increased frequency of visits, including home video conferencing and recommending referrals to nutrition and clinical pharmacists for amultidisciplinary approach. Patient satisfaction was assessed through a validated 5-question survey using a Likert scale 1-5 immediately after each visit. The primary outcomes were change in A1c and patient satisfaction. Results: 95% (17/18) of the participants were males, the mean age was 62.5±.14.0 years-old, and the mean BMI was 34.4±6.8 kg/m(2). Median follow-up time was 189 days (range: 89-417). During follow-up, A1c decreased by 0.8% (baseline: 9.5±2.2 vs. post-visit: 8.7±2.0%, p=0.017).Overall, all patients were fully satisfied (Likert score of 5) with the telediabetes visits and 94% of the patients would choose telehealth over face-to-face appointments. Up to now 37% of patients have had at least a second visit with telediabetes. Conclusion: Telediabetes is an effective alternative to face-to-face visits for rural veterans, as demonstrated in other communities. The high patient satisfaction and decrease in A1c in this study showed that the program can be expanded to increase access to diabetes care in remoteareas. Oxford University Press 2020-05-08 /pmc/articles/PMC7207731/ http://dx.doi.org/10.1210/jendso/bvaa046.1955 Text en © Endocrine Society 2020. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Diabetes Mellitus and Glucose Metabolism Behari, Gauri Vinales, Karyne Lima Correa, Ricardo Rafael Reaven, Peter Harman, Sherman Mitchell SUN-678 Telediabetes Improves A1C and Patient Satisfaction: A Pilot Study in a VA Institution |
title | SUN-678 Telediabetes Improves A1C and Patient Satisfaction: A Pilot Study in a VA Institution |
title_full | SUN-678 Telediabetes Improves A1C and Patient Satisfaction: A Pilot Study in a VA Institution |
title_fullStr | SUN-678 Telediabetes Improves A1C and Patient Satisfaction: A Pilot Study in a VA Institution |
title_full_unstemmed | SUN-678 Telediabetes Improves A1C and Patient Satisfaction: A Pilot Study in a VA Institution |
title_short | SUN-678 Telediabetes Improves A1C and Patient Satisfaction: A Pilot Study in a VA Institution |
title_sort | sun-678 telediabetes improves a1c and patient satisfaction: a pilot study in a va institution |
topic | Diabetes Mellitus and Glucose Metabolism |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7207731/ http://dx.doi.org/10.1210/jendso/bvaa046.1955 |
work_keys_str_mv | AT beharigauri sun678telediabetesimprovesa1candpatientsatisfactionapilotstudyinavainstitution AT vinaleskarynelima sun678telediabetesimprovesa1candpatientsatisfactionapilotstudyinavainstitution AT correaricardorafael sun678telediabetesimprovesa1candpatientsatisfactionapilotstudyinavainstitution AT reavenpeter sun678telediabetesimprovesa1candpatientsatisfactionapilotstudyinavainstitution AT harmanshermanmitchell sun678telediabetesimprovesa1candpatientsatisfactionapilotstudyinavainstitution |