915-P: Characteristics Associated with Improved Blood Glucose Control for a Large Diabetes Population Using a Connected Blood Glucose Meter with CDE Support

Abstract

Background: Managing blood glucose (BG) values within target range (80-180 mg/dL) decreases the risk for acute and chronic complications of diabetes. The Livongo for diabetes Program provides a connected blood glucose meter, unlimited glucose test supplies, digital one-to-one coaching from CDEs. Methods: Medical claims, pharmacy claims, Livongo program use and demographic data for members who had been in the Livongo program for > 3 months with continuous health benefits eligibility 1 year before and after launches of the Livongo program through large self-insured employers (N=1480) were obtained. Hemoglobin A1c was estimated (eA1c) based on BG values captured over 90 days for each member at 3, 6, 9 and 12 months after program activation and compared with HbA1c self-reported at baseline. Associations between eA1c improvements and BG checking patterns, coach interactions, medication adherence, medical spending and demographic characteristics at various time points were assessed using logistic regression models. Results: The odds of improvement in eA1c was significantly higher for people who are older (OR=1.02, p<0.01, CI(1.01-1.03)), have higher self-reported A1c value (OR=1.31, p<0.01, CI(1.22-1.40)), are African American (OR=1.81, p<0.01, CI(1.24-2.64)) and not on medication (OR=1.67, p<0.05, CI(1.005-2.77)). With other characteristics controlled, having more coaching sessions and BG alert contact with coaches was associated with improved eA1c (OR=1.62, p<0.1, CI (0.95-2.76)) and future low BG alerts (OR=1.21, p<0.05, CI(1.04-1.41)) at 12 months. Conclusions: Clinical impact of the Livongo for diabetes program varies based on demographics, clinical and program feature usage. Understanding these associations can improve personalization, member experience and clinical outcomes. These results suggest that real-time technology solutions can improve health for patients. Disclosure W. Lu: None. C. Whaley: Consultant; Self; Livongo Health. S.L. Painter: Employee; Self; Livongo Health. J. Bollyky: Employee; Self; Livongo Health. Stock/Shareholder; Self; Livongo Health.