A telediabetes program for veterans shortened wait times for specialist care and provided comparable blood glucose control rates as traditional in-person care, according to a study set to be presented at ENDO 2018.
The program, which was implemented at the Veterans Affairs (VA) Pittsburgh Healthcare System, provided users an electronic consultation with an endocrinologist specializing in diabetes in addition to ongoing telephone-based care. The program also provides team-based care with a follow-up for improved adherence, important in maintaining blood glucose control in type 2 diabetes patients.
In this study, researchers enrolled 442 veterans with type 2 diabetes in the telediabetes program and compared results to 407 type 2 diabetic veterans who received conventional care. Results showed the remote program was able to provide patients with a specialist consultation within 10 days, compared to the 37 days it took for in in-person consultation. Additionally, both groups saw similar improvements to blood glucose control, which further showcased the tele diabetes programs ability to reach similar results as in-person care.
"Without incurring any travel, our electronic consultation program provides equally efficacious diabetes care with significantly expedited access," said Archana Bandi, MD, the study's senior investigator and the clinical director of Telehealth Services for VA Pittsburgh Healthcare System. "This type of e-consult is a viable alternative to traditional face-to-face care delivery, especially in remote areas with a shortage of endocrinologists."
The program began with the endocrinologist reviewing a patient’s medical records and conducting a 30-minutes phone interview before sending recommendations to a primary care physician on how to control blood sugar levels. A nurse on the diabetes care team then monitored the patient’s progress with ongoing phone calls for three to six months. Data was collected and sent to the primary care physician to make further changes to improve patient care. Additionally, the program provided patients with educational services and nutritional counseling near them.
"Given the obesity and diabetes epidemic along with the current shortage of endocrinologists in the U.S., the care delivery for patients with diabetes needs a complete change in its paradigm," she said. "An example is our innovative model of care delivery that brings quality care to the patient's doorstep in an expedient fashion."