185648 Diabetic and home alone - not any more with Telehealth

Tuesday, October 28, 2008

Lizheng Shi, PhD , Health Systems Management, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
Monika S. Sawhney, PhD , School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
Barbara Gibson, RN , R&R Home care, Metairie, LA
Vivian Fonseca, MD , Section of Endocrinology, Tulane University Health Sciences Center, New Orleans, LA
The number of elderly people living with diabetes continues to rise at an astounding rate. However, most elderly patients with diabetes continue to have chronic or episodic problems of achieving the goals of weight control, medication management, and blood glucose self-monitoring. These problems lead to increased morbidity and mortality, high health care costs and frustration among patients and practitioners. The elderly patients with a diagnosis of diabetes with or without other complex co morbidities in home care settings may benefit from telemedicine to effectively integrate diabetes self-care into their lives over the course of their disease.

This project studies whether or not the Diabetes Living telehealth program based on the Viterion100 Monitor will cost-effectively improve the management of diabetes care in terms of reduction in HbA1c and mitigation of the acute/chronic complications with active patient participation and education using telehealth. Homebound patients (aged >= 65) will be recruited from two health systems in New Orleans for this randomized four month open-label observational study. HbA1c, number of acute hospitalization, total number of urgent visits and emergent visits, and number of home nurse visits will serve as outcome measures. In addition, two rounds of survey at baseline and study completion will be administered to patients on health-related quality of life and satisfaction with diabetes care.

Chi-square or Fisher exact tests will be used to compare the rates of achieving glycemic control goal and acute hospitalization rates between two groups. T-tests will be used to compare the number of home nurse visits and emergent visits. Within the study group, the associations will be tested between patterns of Viterion use (i.e., number of alerts, skips of measures) and outcomes of HbA1c. Preliminary results show considerable reduction in body weight, BMI and HbA1c levels, as well as satisfaction with the telehealth program.

Learning Objectives:
1. Develop an in-depth understanding about benefits of telehealth programs in management of diabetes care among health bound patients. 2. Gain knowledge regarding perception and satisfaction of the participating population regarding telehealth programs. 3. Understand the importance of conducting feasibility studies to inform large scale quality improvement initiatives.

Keywords: Telehealth, Diabetes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a PhD in Pharmacy, Economics and Policy and have years of working in the field of Pharmacy and health care
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.