Remote patient monitoring sustains reductions of hemoglobin A1c in underserved patients to 12 months

  • Elizabeth B. Kirkland
    Correspondence
    Corresponding author at: Department of Internal Medicine, Medical University of South Carolina, 135 Rutledge Ave, MSC 591, Charleston, SC 29425, USA.
    Affiliations
    Division of General Internal Medicine, Department of Medicine, Medical University of South Carolina, 135 Rutledge Ave, MSC 591, Charleston, SC, USA
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  • Justin Marsden
    Affiliations
    Section of Health Systems Research and Policy, Department of Medicine, Medical University of South Carolina, 135 Rutledge Ave, MSC 591, Charleston, SC, USA
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  • Jingwen Zhang
    Affiliations
    Section of Health Systems Research and Policy, Department of Medicine, Medical University of South Carolina, 135 Rutledge Ave, MSC 591, Charleston, SC, USA
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  • Samuel O. Schumann
    Affiliations
    Division of General Internal Medicine, Department of Medicine, Medical University of South Carolina, 135 Rutledge Ave, MSC 591, Charleston, SC, USA
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  • John Bian
    Affiliations
    Section of Health Systems Research and Policy, Department of Medicine, Medical University of South Carolina, 135 Rutledge Ave, MSC 591, Charleston, SC, USA
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  • Patrick Mauldin
    Affiliations
    Section of Health Systems Research and Policy, Department of Medicine, Medical University of South Carolina, 135 Rutledge Ave, MSC 591, Charleston, SC, USA
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  • William P. Moran
    Affiliations
    Division of General Internal Medicine, Department of Medicine, Medical University of South Carolina, 135 Rutledge Ave, MSC 591, Charleston, SC, USA
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Published:January 25, 2021DOI:https://doi.org/10.1016/j.pcd.2021.01.005

      Highlights

      • Remote patient monitoring (RPM) is an effective, accessible tool for diabetes care.
      • Rural and underserved populations achieved significant improvements in HbA1c.
      • HbA1c reductions were sustained at 6 and 12 months of RPM program participation.
      • Patients of varying demographics and clinic types achieved similar clinical benefit.

      Abstract

      Aims

      We 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.

      Methods

      Demographic 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.

      Results

      HbA1c 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.

      Conclusions

      Patients 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

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