Intensive Use of Telehealth Improves Glycemic Control Among Rural Patients with Type 2 Diabetes
Veterans Health Administration program combining telemonitoring, self-management and medication support improves HbA1c levels within six months
In a project entitled “Implementation of Intensive Telehealth Intervention for Rural Patients with Uncontrolled Diabetes,” researchers revealed improved HbA1c levels among rural patients with poorly-controlled type 2 diabetes who participated in a comprehensive telehealth program. The results were presented today at the American Diabetes Association’s® (ADA’s) 80th Virtual Scientific Sessions®. The study found a 1.36% reduction in HBA1c levels after six months of care, and indicated patients maintained the improvement up to 18 months after beginning the program.
Current information shows managing diabetes in rural areas is difficult due to limited access to specialty care and self-management programs. Specialists set out to address these challenges in a clinically feasible manner by strategically designing an intensive diabetes management intervention called Advanced Comprehensive Diabetes Care (ACDC). Under an award from the VA Office of Rural Health Veterans Rural Health Resource Center- Iowa City, the researchers built the program for delivery using the existing Veterans Health Administration’s Home Telehealth (VHA HT) infrastructure and clinical staff.
ACDC is a six-month telehealth intervention that combines telemonitoring with module-based self-management support and medication management. Existing clinical staff with VHA HT delivered ACDC through bi-monthly half-hour calls. In an earlier randomized trial, researchers found that ACDC improved HbA1c, blood pressure and diabetes self-care in the initial 50 veterans who participated. Since 2017, ACDC has been implemented in clinical practice at seven VHA sites around the country that serve rural veterans.
The most recent analysis examined 125 patients receiving ACDC at five sites. Across all locations, the patients’ average HbA1c levels improved from 9.25% at baseline to 7.89% at 6 months, a benefit that largely persisted 18 months after the start of the study. On qualitative analyses, ACDC enhanced patient engagement and awareness of diabetes control.
“We are pleased to see that the intervention was well-suited for delivery in clinical practice and that it remained effective in real-world settings,” said Elizabeth Kobe, a study investigator and MD candidate at Duke University Medical School. “When telehealth interventions are designed to leverage existing resources, they can greatly improve diabetes care in underserved rural populations. We also believe this design-minded approach can extend to other chronic diseases.”
Research presentation details:
- Ms. Kobe will present the research at 5:00 p.m. during the session listed below.
- Session: Addressing Challenges to Diabetes Care Delivery
- Date: Friday, June 12, 5:00 – 7:00 p.m. CT (all sessions will be recorded and available for viewing for up to 90 days)
- Abstract: 21-OR
For more information or to schedule an interview with Ms. Kobe or principal investigator Matthew Crowley, MD, please contact Daisy Diaz by phone at (703) 253-4807 or by email at SciSessionsPress@diabetes.org. For additional information about the VA Office of Rural Health, click here.
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About the ADA’s Scientific Sessions
The ADA’s 80th Scientific Sessions, the world’s largest scientific meeting focused on diabetes research, prevention and care, will be held virtually June 12-16, 2020. Leading physicians, scientists and health care professionals from around the world will unveil cutting-edge research, treatment recommendations and advances toward a cure for diabetes. Though the conference will be remote this year, attendees will receive exclusive access to nearly 2,000 original research presentations and take part in provocative and engaging exchanges with leading diabetes experts. Learn more and register at scientificsessions.diabetes.org and join the Scientific Sessions conversation on social media using #ADA2020 and #ADAGoesVirtual.
About the American Diabetes Association
Every day more than 4,000 people are newly diagnosed with diabetes in America. More than 122 million Americans have diabetes or prediabetes and are striving to manage their lives while living with the disease. The American Diabetes Association (ADA) is the nation’s leading voluntary health organization fighting to bend the curve on the diabetes epidemic and help people living with diabetes thrive. For nearly 80 years the ADA has been driving discovery and research to treat, manage and prevent diabetes, while working relentlessly for a cure. We help people with diabetes thrive by fighting for their rights and developing programs, advocacy and education designed to improve their quality of life. Diabetes has brought us together. What we do next will make us Connected for Life. To learn more or to get involved, visit us at diabetes.org or call 1-800-DIABETES (1-800-342-2383). Join the fight with us on Facebook (American Diabetes Association), Twitter (@AmDiabetesAssn) and Instagram (@AmDiabetesAssn).