Telehealth Services Evaluated Vs Standard Care for Diabetes

A 2019 meta-analysis of 42 clinical trials indicated that telemedicine may be more effective than standard care in managing diabetes. In the community setting, telehealth services can include initial and follow-up appointments, specialist appointments, and pharmacist appointments for diabetes, hypertension, and medication management, in addition to interpreter services, health education, and social work consultations.

Researchers set out to evaluate the impact of the Diabetes Care Group initiative at CommunityHealth clinics in Chicago—an effort that includes clinical pharmacists or nurses who manage patients with diabetes and those with an HbA1c ≥9% via telephone or video-based health services. In the current study, the telehealth program (DCG-TH group; n=186) was compared with a group of patients who received telehealth care and on-site visits with a primary care provider (PCP group; N=116) and those who had scheduled diabetes management appointments in the clinic (DCG on-site group; n=45).

Researchers identified a significant between-group difference in the number of total provider visits. At baseline, HbA1c was “significantly higher” in the DCG on-site group vs the other 2 patient groups. There was also a significant between-group difference in immunization status; those in the DCG-TH group were more likely to be up to date on vaccines including those for influenza and pneumococcal. However, there was no significant difference in preventive screenings, particularly in eye exams.

Study limitations include an unequal baseline HbA1c between groups, the short study duration, and a lack of assessment of patients who stopped seeking care during the study period.

“A telehealth diabetes management program (telephone or video visits) may be a successful method to improve diabetes management by 1) lowering A1c and 2) improving immunization rates,” the researchers said. “A comprehensive telehealth diabetes care model, which includes assessing transpiration as a barrier [to care], can lead to better coordination of care and access…in a low income, uninsured population.”

Reference

Babul NS, Salama J, Khaja F, et al. Impact of a telehealth diabetes program on changes in A1c and preventative care measures in a low-income, uninsured patient population. Presented at: American Pharmacists Association 2022 Annual Meeting & Exposition; March 18-21, 2022; San Antonio, TX