Background: The prevalence of diabetes in rural and remote North Queensland is twice that of the general Australian population. The vast geographical distances in North Queensland prevent patients from accessing specialist diabetes care in tertiary hospitals. Telehealth (TH) presents a unique opportunity to overcome this barrier. However, the ability of TH to improve glycaemic control and vascular risk factors (blood pressure, body mass index, lipid profile) in comparison to traditional face-to-face (FTF) care in this population remains unknown.
Methods: This was a retrospective cohort study of all diabetes-related telehealth consultations conducted at the Townsville Hospital from January 2016 to March 2018. The primary outcome was the change in HbA1c post-FTF (face-to-face) care versus post-TH care. Secondary outcomes included change in blood pressure, body mass index and lipid profile. We conducted a preliminary economic analysis to determine patient cost-savings from the tele-diabetes model of care.
Results: 330 patients were included in the study. The majority (71%) had a diagnosis of type 2 diabetes. The median baseline HbA1c was 9.1% (8.0-10.8). HbA1c improved from 9.1% (post-FTF) to 8.1% post-TH intervention (z = -9.184, p<0.001). We observed a reduction in total cholesterol levels (4.15 mmol/L to 4.00 mmol/L; z = -3.198, p<0.001) and LDL-cholesterol (2.00 mmol/L to 1.80 mmol/L; z = -4.209, p<0.001). The tele-diabetes model was associated with a total patient cost-savings of $131,710 (equating to $390 in cost-savings per patient per trip).
Conclusions: Telehealth consultations improved glycaemic control and lipid levels more effectively than traditional face-to-face care with significant cost savings for a rural and remote population in North Queensland, Australia.
N. Nangrani: None. U. Malabu: None. V. Vangaveti: None.