Virtual Education for Older Adults with Type 2 Diabetes during Transitions

Abstract

Compared to older adults without type 2 diabetes (T2D) older adults with T2D have higher rates of hospital admission and readmission. Despite having a diagnosis of T2D, attendance of diabetes self-management education (DSME) classes by older adults is low. Hospitalizations are an opportune time to engage older adults with T2D, currently no interventions exist utilizing telehealth and DSME for this population during transitions. The purpose of this study is to demonstrate the feasibility of providing DSME through telehealth to older patients with T2D following a hospital admission. We conducted a qualitative study using semi-structured, face-to-face interviews with older adults with T2D engaged in a post-discharge DSME telehealth transitions intervention. Hospitalized older adults (≥ 55 years of age) with T2D were recruited. An advanced practice nurse certified diabetes educator provided one in-person home visit within 48 hours of discharge and weekly DSME sessions via electronic tablet for four additional weeks. After completion of the program, eight patients were asked to describe their experience using the tablet to receive DSME, describe any behavior changes, and if they would accept future education virtual visits. Interviews were audio-recorded, transcribed verbatim and content analyzed thematically. Participants (50% male, aged 57-73 years, 75% African American), cited inconvenience and lack of availability as the leading cause for prior DSME non-attendance. Participants described an increased awareness of dietary habits and more frequent monitoring of glucose. Seven out of 8 participants indicated they would participate in future virtual DSME sessions. Every participant indicated the technology was easy to use and would recommend sessions to others. Our findings support ADA recommendations to improve transitions and to evaluate DSME need at this critical time. Technology use is feasible to enhance availability and convenience for continued DSME in the home after a hospital admission. Disclosure C.R. Whitehouse: None. J.A. Long: None. L. McLeer Maloney: None. D.A. Horowitz: None. K. Bowles: None.