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Remote patient monitoring sustains reductions of hemoglobin A1c in underserved patients to 12 months
Authors:Elizabeth B Kirkland  Justin Marsden  Jingwen Zhang  Samuel O Schumann  John Bian  Patrick Mauldin  William P Moran
Institution:1. Division of General Internal Medicine, Department of Medicine, Medical University of South Carolina, 135 Rutledge Ave, MSC 591, Charleston, SC, USA;2. Section of Health Systems Research and Policy, Department of Medicine, Medical University of South Carolina, 135 Rutledge Ave, MSC 591, Charleston, SC, USA
Abstract:AimsWe sought to determine whether underserved patients enrolled in a statewide remote patient monitoring (RPM) program for diabetes achieve sustained improvements in hemoglobin A1c at 6 and 12 months and whether those improvements are affected by demographic and clinical variables.MethodsDemographic and clinical variables were obtained at baseline, 6 months and 12 months. Baseline HbA1c values were compared with those obtained at 6 and 12 months via paired t-tests. A multivariable regression model was developed to identify patient-level variables associated with HbA1c change at 12 months.ResultsHbA1c values were obtained for 302 participants at 6 months and 125 participants at 12 months. Compared to baseline, HbA1c values were 1.8% (19 mmol/mol) lower at 6 months (p < 0.01) and 1.3% (14 mmol/mol) lower at 12 months (p < 0.01). Reductions at 12 months were consistent across clinical settings. A regression model for change in HbA1c showed no statistically significant difference for patient age, sex, race, household income, insurance, or clinic type.ConclusionsPatients enrolled in RPM had improved diabetes control at 6 and 12 months. Neither clinic type nor sociodemographic variables significantly altered the likelihood that patients would benefit from this type of technology. These results suggest the promise of RPM for delivering care to underserved populations.
Keywords:Telemedicine  Underserved populations  Health disparities  Remote monitoring  Primary care
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