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Published Online: 22 September 2011

Using Telehealth to Provide Diabetes Care to Patients in Rural Montana: Findings from the Promoting Realistic Individual Self-Management Program

Publication: Telemedicine and e-Health
Volume 17, Issue Number 8

Abstract

Objective: The objectives of this study were to demonstrate the feasibility of telehealth technology to provide a team approach to diabetes care for rural patients and determine its effect on patient outcomes when compared with face-to-face diabetes visits. Materials and Methods: An evaluation of a patient-centered interdisciplinary team approach to diabetes management compared telehealth with face-to-face visits on receipt of recommended preventive guidelines, vascular risk factor control, patient satisfaction, and diabetes self-management at baseline and 1, 2, and 3 years postintervention. Results: One-year postintervention the receipt of recommended dilated eye exams increased 31% and 43% among telehealth and face-to-face patients, respectively (p=0.28). Control of two or more risk factors increased 37% and 69% (p=0.21). Patient diabetes care satisfaction rates increased 191% and 131% among telehealth and face-to-face patients, respectively (p=0.51). A comparison of telehealth with face-to-face patients resulted in increased self-reported blood glucose monitoring as instructed (97% vs. 89%; p=0.63) and increased dietary adherence (244% vs. 159%; p=0.86), respectively. Receipt of a monofilament foot test showed a significantly greater improvement among face-to-face patients (17% vs. 35%; p=0.01) at 1 year postintervention, but this difference disappeared in years 2 and 3. Conclusions: Telehealth proved to be an effective mode for the provision of diabetes care to rural patients. Few differences were detected in the delivery of a team approach to diabetes management via telehealth compared with face-to-face visits on receipt of preventive care services, vascular risk factor control, patient satisfaction, and patient self-management. A team approach using telehealth may be a viable strategy for addressing the unique challenges faced by patients living in rural communities.

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Information & Authors

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Published In

cover image Telemedicine and e-Health
Telemedicine and e-Health
Volume 17Issue Number 8October 2011
Pages: 596 - 602
PubMed: 21859347

History

Published in print: October 2011
Published online: 22 September 2011
Published ahead of print: 22 August 2011
Accepted: 25 March 2011
Revision received: 23 March 2011
Received: 4 February 2011

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Affiliations

Elizabeth Ciemins
Billings Clinic Center for Clinical Translational Research, Billings, Montana.
Patricia Coon
Billings Clinic Center for Clinical Translational Research, Billings, Montana.
Rory Peck
Billings Clinic Center for Clinical Translational Research, Billings, Montana.
Barbara Holloway
Billings Clinic Center for Clinical Translational Research, Billings, Montana.
Sung-Joon Min
Division of Health Care Policy and Research, University of Colorado, Aurora, Colorado.

Notes

Address correspondence to:Elizabeth Ciemins, Ph.D., M.P.H., M.A.Billings Clinic Center for Clinical Translational Research2800 Tenth Ave.Billings, MT 59107E-mail: [email protected]

Disclosure Statement

No competing financial interests exist.

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