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Abstract
<p class="first" id="d5654582e83">Background/Introduction: Ineffective management
of chronic illness and lack of referral
sources in underserved areas has contributed to increased health care spending and
a decline in quality of life for the affected. In 2016, 15.4% of the adult population
of Mississippi had diabetes. Telehealth in the home is a viable way to bring a care
team to patients to assist them as they manage their illnesses. The purpose of the
study was to determine the relationship between the Mississippi Diabetes Telehealth
Network clinical care model and selected diabetes outcomes over time. Methods: A prospective,
longitudinal cohort study design evaluated the relationship between using telehealth
for chronic care management and diabetes outcomes over a 12-month period. Eligible
participants were patients over 18 years old diagnosed with diabetes at a rural health
clinic with an hemoglobin A1c (HbA1c) ≥7.0%. Rolling enrollment continued until the
pool of eligible participants was depleted. A total of 171 were enrolled. Results:
There was a significant difference in HbA1c values from baseline to 3-, 6-, 9-, and
12-month values. A significant difference was found between baseline and 12-month
measures for total cholesterol, low density lipoproteins (LDL), high density lipoproteins
(HDL), triglycerides, creatinine clearance, glomerular filtration rate, and potassium.
There were no differences in baseline and 12-month measures for weight, blood pressure,
blood urea nitrogen (BUN), and microalbumin. Discussion/Conclusions: Even with the
limited sample size and design, remote patient monitoring and telehealth may be an
effective tool for assisting home-based patients in the self-management of diabetes
in rural areas. The maximum benefit was achieved after 3-4 months on the program and
maintained over the 12-month period.
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