Session: OR32-Health Outcomes & Quality Improvement
Room 301 (Moscone Center)
HYPOTHESIS: The purpose of this study is to compare effectiveness of E-consultation to in-person consultation for diabetes management. The primary outcome is change in HbA1c from pre-consultation to 6 months post-consultation in each group. We anticipated E-consultation would be equally or more effective than in-person consultation in lowering HbA1c.
METHODS: A retrospective chart review of patients referred for diabetes consultation at the MEDVAMC from November 1, 2011 to April 20, 2012 was conducted. Patients were divided into two groups: (1) patients seen in-person by an Endocrinologist and (2) patients evaluated via the E-consultation system. Inclusion criteria included type 2 DM and HbA1c >8%. Patients who were pregnant, on insulin pump, had no phone access, type 1 DM, did not receive primary care at the VA, or had seen an endocrinologist in the previous one year were excluded.
RESULTS: Ninety-three patients met inclusion/exclusion criteria for in-person clinic visits compared to 281 patients in the E-consult group. The mean HbA1c for patients seen in-person at baseline and 6 months was 10.3% and 9.3%, respectively [p <0.001]. The mean HbA1c for patients evaluated by E-consultation at baseline and 6 months was 10.1% and 9.1%, respectively [p <0.001]. There was no statistically significant difference in change in HbA1c from baseline to 6 months between the two groups: each group lowered HbA1c by 1 percentage point [p =0.76]. Other results, including change in total insulin dose, blood pressure, lipids, and BMI, will be presented.
CONCLUSION: E-consultation management for DM is as effective as in-person clinic management of DM at the MEDVAMC.
Nothing to Disclose: PP, BJ, SH, MG, MV, MM, SNM
*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm
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