Effect of a Comprehensive Telehealth Intervention vs Telemonitoring and Care Coordination in Patients With Persistently Poor Type 2 Diabetes Control
By Hayden Bosworth, Phillip E. Tarkington, Matthew J. Crowley, et al.
A Duke University-led study assessed the clinical value of a comprehensive telehealth intervention targeting adults with persistently poorly controlled type 2 diabetes (PPDM). The sample population included 200 men and women whose blood glucose level measured 8.5% or greater for at least 1 year despite routine or specialized care. One-half of the participants were randomly assigned to the comprehensive telehealth intervention, which entailed telemonitoring, self-management support, diet and activity support, medication management, and depression support for 12 months. The remainder received a more basic intervention that coupled telemonitoring with care coordination only. At 1-year followup, blood glucose levels declined 1.59% in the cohort that received the comprehensive intervention vs. 0.98% among the participants who received the simpler intervention. Patients receiving the comprehensive tool also registered greater improvements in diabetes distress, diabetes self-care, and self-efficacy. The multi-faceted clinical improvements were achieved at what study authors considered to be a reasonable additional cost of $1,519 per patient per year. "This study supports consideration of comprehensive telehealth implementation for PPDM in systems with appropriate infrastructure and may enhance the value of telehealth during the COVID-19 pandemic and beyond," they conclude.
Read more on JAMA Internal Medicine.