Ongoing support is critical for effective diabetes (DM) self-management, but difficult to deliver, particularly in areas with limited resources. The purpose of the study was to assess the impact of a virtual support model on DM outcomes for high-risk patients in rural underserved communities.
Methods: Patients with HbA1c>9% receiving care in federally qualified centers were referred to the Telemedicine for Reach, Education, Access, Treatment and Ongoing Support (TREAT-ON) program, where a Diabetes Care and Education Specialist (DCES) provided in person diabetes self-management education and ongoing support through videoconferencing. Participant demographics, BMI and HbA1c were collected from patient records. Participants completed the DM Summary of Self-Care Activities, Distress and Empowerment Scales and Morisky Medication Adherence Measure at baseline and 6 months, and the Telehealth Usability Questionnaire at study completion. Pre/post values were compared for HbA1c, self-care, psychosocial and process outcomes.
Results: Participants (n=37) were 84% white, mean age 46.1 years with mean BMI 37.5. Glycemia improved with a mean reduction in HbA1c from 11.2% at baseline to 9.1% at follow-up (p<.001) . There was significant improvement in self-care behaviors of general diet (p=.001) and foot care (p=.041) . DM distress was reduced significantly (p<.001) , attributed to less emotional and regimen distress. Participants also reported a high level of satisfaction with TREAT-ON and interest in future use (4.6/5 points) .
Conclusions: Findings offer evidence of significant benefits and acceptability of a video-conferencing delivery model for DM self-management support. Future research should explore additional ways to empower individuals to continue and sustain improvements.
R.Hammoudeh: None. J.S.Krall: Research Support; Becton, Dickinson and Company, Sanofi. P.A.Johnson: None. S.L.Reynolds: None. K.Ruppert: None. J.Ng: Research Support; Sanofi. L.M.Siminerio: Advisory Panel; Abbott, Bayer AG, Research Support; Becton, Dickinson and Company, Sanofi.
National Institute of Diabetes Digestive and Kidney Diseases of the National Institutes of Health (R34DK123370) .