Access to telehealth and changes in diabetes care patterns during the pandemic: evidence from a large integrated health system in the Southeast USA
Authors' conclusion
Telehealth use increased during the pandemic and alleviated some of the observed declines in routine diabetes care and management.
Study context
- Population
- Adults (≥18 years) with prevalent diabetes as of January 1, 2018, continuously enrolled at Kaiser Permanente Georgia through December 31, 2021
- Participants
- 22,854 adults
- Exposure
- During vs pre COVID-19, by telehealth use
- Outcome
- Within-subject change in adherence to seven annual routine care processes (BP, hemoglobin A1C (HbA1c), cholesterol, creatinine, urine-albumin-creatinine ratio (UACR), eye and foot examinations), pre vs during COVID-19
- Follow-up
- Pre (2018-2019) vs during (2020-2021)
Methodological detailsintegrated health system, within-subject pre vs during COVID-19 comparison, generalized estimating equations
- Integrated health system
- Within-subject pre vs during COVID-19 comparison
- Generalized estimating equations
Main finding
As reported in the abstract
Adherence to routine care processes, during vs pre pandemic · 2020-2021 vs 2018-2019
Adherence to all care processes declined in telehealth users (range: 1.6% for foot examinations to 12.4% for blood pressure (BP))
1.6% to 12.4%
Adherence to all care processes declined in non-telehealth users (range: 1.9% for foot examinations to 40.7% for BP)
1.9% to 40.7%
Observational data: associations, not effects.
Further findings
| Outcome | Mean difference (%) (95% CI) | |
|---|---|---|
| Laboratory measures in telehealth users, during vs pre COVID-19During COVID-19vs Pre COVID-19HbA1c; worsened | 0.4 (0.2%–0.6%) | |
| −0.500.51Difference, % (linear scale) |
| Outcome | OR (95% CI) | |
|---|---|---|
| Laboratory measures in telehealth users, during vs pre COVID-19During COVID-19vs Pre COVID-19UACR: odds of elevated kidney disease risk increased by 48% | 1.48 (1.36–1.62) | |
| 0.512Odds ratio (log scale) |
| Outcome | Estimate |
|---|---|
| Laboratory measures in telehealth users, during vs pre COVID-19During COVID-19 vs Pre COVID-19 · Systolic BP; worsened | 1.62 mm Hg (95% CI 1.44–1.81) |
| Laboratory measures in telehealth users, during vs pre COVID-19During COVID-19 vs Pre COVID-19 · Creatinine; worsened | 0.03 mg/dL (95% CI 0.02–0.04) |
| Laboratory measures in telehealth users, during vs pre COVID-19During COVID-19 vs Pre COVID-19 · LDL-C; improved | −9.08 mg/dL (95% CI −9.77 to −8.39) |
Proportion of telehealth users · 2018-2019 to 2020-2021
- Telehealth users increased from 38.7% (2018-2019) to 91.5% (2020-2021)
- 38.7% to 91.5%
Laboratory measures in telehealth users, during vs pre COVID-19
- Patterns were similar in non-telehealth users
Original publication
Access to telehealth and changes in diabetes care patterns during the pandemic: evidence from a large integrated health system in the Southeast USA. BMJ Open Diabetes Res Care. Published 27 February 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →