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The utilization of video-conference shared medical appointments in rural diabetes care.

Publication ,  Journal Article
Tokuda, L; Lorenzo, L; Theriault, A; Taveira, TH; Marquis, L; Head, H; Edelman, D; Kirsh, SR; Aron, DC; Wu, W-C
Published in: Int J Med Inform
September 2016

AIM: To explore whether Video-Shared Medical Appointments (video-SMA), where group education and medication titration were provided remotely through video-conferencing technology would improve diabetes outcomes in remote rural settings. METHODS: We conducted a pilot where a team of a clinical pharmacist and a nurse practitioner from Honolulu VA hospital remotely delivered video-SMA in diabetes to Guam. Patients with diabetes and HbA1c ≥7% were enrolled into the study during 2013-2014. Six groups of 4-6 subjects attended 4 weekly sessions, followed by 2 bi-monthly booster video-SMA sessions for 5 months. Patients with HbA1c ≥7% that had primary care visits during the study period but not referred/recruited for video-SMA were selected as usual-care comparators. We compared changes from baseline in HbA1c, blood-pressure, and lipid levels using mixed-effect modeling between video-SMA and usual care groups. We also analyzed emergency department (ED) visits and hospitalizations. Focus groups were conducted to understand patient's perceptions. RESULTS: Thirty-one patients received video-SMA and charts of 69 subjects were abstracted as usual-care. After 5 months, there was a significant decline in HbA1c in video-SMA vs. usual-care (9.1±1.9 to 8.3±1.8 vs. 8.6±1.4 to 8.7±1.6, P=0.03). No significant change in blood-pressure or lipid levels was found between the groups. Patients in the video-SMA group had significantly lower rates of ED visits (3.2% vs. 17.4%, P=0.01) than usual-care but similar hospitalization rates. Focus groups suggested patient satisfaction with video-SMA and increase in self-efficacy in diabetes self-care. CONCLUSION: Video-SMA is feasible, well-perceived and has the potential to improve diabetes outcomes in a rural setting.

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Published In

Int J Med Inform

DOI

EISSN

1872-8243

Publication Date

September 2016

Volume

93

Start / End Page

34 / 41

Location

Ireland

Related Subject Headings

  • Videoconferencing
  • Self Care
  • Rural Population
  • Prospective Studies
  • Primary Health Care
  • Pilot Projects
  • Pharmacists
  • Patient Satisfaction
  • Middle Aged
  • Medication Adherence
 

Citation

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Chicago
ICMJE
MLA
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Tokuda, L., Lorenzo, L., Theriault, A., Taveira, T. H., Marquis, L., Head, H., … Wu, W.-C. (2016). The utilization of video-conference shared medical appointments in rural diabetes care. Int J Med Inform, 93, 34–41. https://doi.org/10.1016/j.ijmedinf.2016.05.007
Tokuda, Lisa, Lenora Lorenzo, Andre Theriault, Tracey H. Taveira, Lynn Marquis, Helene Head, David Edelman, Susan R. Kirsh, David C. Aron, and Wen-Chih Wu. “The utilization of video-conference shared medical appointments in rural diabetes care.Int J Med Inform 93 (September 2016): 34–41. https://doi.org/10.1016/j.ijmedinf.2016.05.007.
Tokuda L, Lorenzo L, Theriault A, Taveira TH, Marquis L, Head H, et al. The utilization of video-conference shared medical appointments in rural diabetes care. Int J Med Inform. 2016 Sep;93:34–41.
Tokuda, Lisa, et al. “The utilization of video-conference shared medical appointments in rural diabetes care.Int J Med Inform, vol. 93, Sept. 2016, pp. 34–41. Pubmed, doi:10.1016/j.ijmedinf.2016.05.007.
Tokuda L, Lorenzo L, Theriault A, Taveira TH, Marquis L, Head H, Edelman D, Kirsh SR, Aron DC, Wu W-C. The utilization of video-conference shared medical appointments in rural diabetes care. Int J Med Inform. 2016 Sep;93:34–41.
Journal cover image

Published In

Int J Med Inform

DOI

EISSN

1872-8243

Publication Date

September 2016

Volume

93

Start / End Page

34 / 41

Location

Ireland

Related Subject Headings

  • Videoconferencing
  • Self Care
  • Rural Population
  • Prospective Studies
  • Primary Health Care
  • Pilot Projects
  • Pharmacists
  • Patient Satisfaction
  • Middle Aged
  • Medication Adherence