Utilizing clinical video telehealth to improve access and optimize pharmacists’ role in diabetes management

Abstract

ObjectivesTo evaluate whether clinical pharmacy specialist (CPS) services delivered using clinical video telehealth (CVT) is consistent with CPS services via face-to-face (FTF) visits in a cohort of patients with poorly controlled type 2 diabetes mellitus. In addition, the study aimed to evaluate the potential benefits for the patient with implementation of CVT services. MethodsSingle-center retrospective cohort study. FTF services provided at a single community-based outpatient clinic (CBOC). CVT services provided at a main campus targeting the same CBOC. Patients with type 2 diabetes mellitus (A1c > 7%) consulted for management by a CPS between April 2013 and October 2014 were included. The primary outcome was mean A1c reduction at 3 and 6 months. Secondary outcomes included time from consult placement to visit, average travel distance averted, and average travel time averted. ResultsMean A1c reduction at 3 months was 1.096 ± 1.8 for FTF services before CVT (P ≤ 0.0001), 1.839 ± 1.7 for FTF services after CVT (P ≤ 0.0001), and 2.262 ± 2.8 (P = 0.0004) for CVT services. At 6 months, the mean A1c reduction was 1.202 ± 1.9 (P ≤ 0.0001), 1.965 ± 2 (P ≤ 0.0001), and 2.610 ± 3.8 (P = 0.0004). At 6 months there was no statistical difference between groups. The average time in days from consult placement to initial visit decreased from 106.3 ± 24.5 to 46 ± 35.3 (P ≤ 0.0001). The average travel distance in miles averted per patient was 99.5 ± 20.3, and the average travel time in hours averted was 1.6 ± 0.3. ConclusionsDiabetes care provided by a CPS via CVT was as effective for the management of type 2 diabetes compared to FTF management by a CPS. Implementation of telehealth services increased access to providers as shown by the reduction in time from consult placement until initial visit.