Abstract 13694: Remote Cardiovascular Health Program Improved Risk Factor Control in Patients With Diabetes

Abstract

Introduction: Patients with diabetes are at significantly increased risk of developing future cardiovascular events. Systematic approaches to optimally control cholesterol and blood pressure (BP) can reduce the morbidity and mortality associated with diabetes. Methods: The Digital Care Transformation (DCT) program screens and refers patients for remote cholesterol and hypertension management and subsequently educates, starts and titrates medications and monitors laboratory values through expert-designed algorithms. Patients referred into the DCT program who had established diabetes were assessed to understand therapy decisions and BP and cholesterol outcomes. Results: 3,294 patients with known diabetes have been enrolled from the DCT program. 249 patients have completed only BP management, 951 completed only cholesterol management and 58 completed both programs. ~26% of patients in both programs also had ASCVD. Mean office BP measurements were146/79 mmHg. Patients without white coat hypertension had a weekly average home BP of 134/77 mmHg. Patients in BP management who were hypertensive on home monitoring and completed the program attained a mean BP fall of 9.3/5.4 mmHg, with a mean 2.9 medication changes over an average of 3.9 months. Patients in cholesterol management had a mean baseline LDL cholesterol of 118 mg/dL. These patients underwent 1.5 medication changes to attain a mean 50.6 mg/dL LDL-c reduction over an average of 4.2 months. Conclusions: A population health management tool implemented by an algorithm-based medication management approach can appropriately prescribe therapy and improve hypertension and cholesterol control in patients with diabetes. Patients at high risk of developing a future cardiovascular events can reduce their risk through the DCT program. Further study is warranted to assess the cost-effectiveness of these interventions at scale.