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Clinical Trial
. 2023 Sep;17(5):1190-1197.
doi: 10.1177/19322968231180884. Epub 2023 Jun 20.

Examining a Diabetes Self-Management Education and Support Telemedicine Model With High-Risk Patients in a Rural Community

Linda Siminerio  1 , Jodi Krall  2 , Patricia Johnson  2 , Kristine Ruppert  3 , Rawan Hammoudeh  1   2 , Archana Bandi  1   4 , Jason M Ng  1   2
Affiliations
Clinical Trial

Examining a Diabetes Self-Management Education and Support Telemedicine Model With High-Risk Patients in a Rural Community

Linda Siminerio et al. J Diabetes Sci Technol. 2023 Sep.

Abstract

Background: Ongoing support is critical to diabetes self-management education and support (DSMES) effectiveness, but difficult to realize, particularly in areas with limited resources. The objective of this feasibility study was to assess the impact of a virtual support model on diabetes outcomes and acceptability with high-risk patients with type 2 diabetes in a rural community.

Methods: In a 12-month nonrandomized trial in federally qualified health centers (FQHCs), patients with hemoglobin A1c (HbA1c) >9% were referred to the Telemedicine for Reach, Education, Access, Treatment, and Ongoing Support (TREAT-ON) program where a Diabetes Care and Education Specialist provided DSMES through videoconferencing. HbA1c change was compared in 30 patients in the intervention group (IG) to a propensity score-matched retrospective control group (CG) of patients who received in-person DSMES delivered by a DCES. Changes in HbA1c, diabetes distress, empowerment, self-care and acceptability were assessed within the intervention group (IG) between those who did and did not meet self-management goals.

Results: The IG experienced similar significant reductions in HbA1c as the CG. Most (64%) IG participants achieved their self-management goal. Goal attainers had a significant HbA1c decrease of 0.21% every 3 months as well as significant reduction in diabetes distress and improvement in general dietary intake. Regardless of goal attainment, IG participants reported high levels of acceptability with TREAT-ON.

Conclusions: This feasibility study suggests that TREAT-ON was well-received and as effective as traditional in-person DSMES. While findings augment ample evidence regarding DSMES benefits, the TREAT-ON model offers additional advantages and provides validation for telehealth to inform future practice in reaching and supporting self-management for high-risk patients in underserved areas.

Trial registration: Clinicaltrials.gov, # NCT04107935.

Keywords: diabetes education; self-management; telemedicine; type 2 diabetes.

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Conflict of interest statement

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: LS, JK, and JN had research support from Becton, Dickinson and Company, and Sanofi, Inc. LS also served on the Bayer Advisory Board.

Figures

Figure 1.
Figure 1.
Overview of TREAT-ON model of care. Abbreviations: TREAT-ON, telemedicine for reach, education, access, treatment, and ongoing support; DM, diabetes mellitus; PCP, primary care provider.
See this image and copyright information in PMC

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