Structured Outpatient Diabetes Education and Telehealth Follow-up to Improve HbA 1c.

Abstract

More than 10% of Americans have diabetes, with higher rates in Hispanics and African Americans. National Healthy People 2030 goals for expected decrease in HbA 1c levels have not been met. No standardized diabetes education or follow-up existed at a free clinic. Patients exhibited diabetic self-management inadequacies and elevated HbA 1c levels. A pre/postimplementation study design was used to evaluate changes in HbA 1c levels, medication adherence, missed appointments, and emergency department visits. Structured diabetes education and follow-up text/phone messages for patients with HbA 1c levels 8% or higher were implemented over 3 months. Outcome data were available for 27 of the 34 participants. Postimplementation, there was a significant 1.7% decrease in mean HbA 1c levels ( P < .001). No significant differences were found for the other outcome measures. Structured diabetes education and follow-up text/phone messages in a free clinic improved patients' HbA 1c levels.