Pharmacist-led Telehealth Diabetes Management Improved Rural Veterans’ Glycemic Control During Pandemic

Pharmacist-provided telehealth diabetes management helped veterans improve or maintain glycemic control during the pandemic. Researchers published their findings in the Journal of the American Pharmacists Association.

At the onset of the COVID-19 pandemic in the United States, telehealth allowed clinical pharmacist practitioners in the Western North Carolina VA Health Care System “to continue to provide diabetes management to veterans with health care disparities, including rural veterans,” investigators said. They conducted an analysis to determine how effective the rapid adoption of telehealth was for improving outcomes and reducing disparities in care.

Included in the study were veterans who had a face-to-face meeting with a pharmacist between June and December 2019 and then transitioned to telehealth appointments between June and December 2020. Patients were not eligible for the analysis if they had previously participated in a VA diabetes management program.

A total of 522 veterans who were predominantly older (79%) and White (89.8%) participated. After telehealth was implemented, HbA1c control was improved or maintained in 84.2% of patients.

Investigators also noted there were widespread metformin sustained action recalls during the study period, resulting in 10.9% of patients discontinuing metformin.

“Given the evidence of metformin’s ability to provide improvement in HbA1c,” they said, “due diligence was warranted to review this potential impact during the same time frame.”

Approximately 76% of the veterans lived in rural areas, and before the pandemic, over half (52%) of patients had to travel more than 50 miles total to receive face-to-face care. Telehealth therefore presents an opportunity for cost and time savings for veterans living in rural communities, study authors said.

“This provides evidence to support the continued widespread telehealth utilization to effectively manage [diabetes mellitus] and reach veterans with health care disparities, particularly rural communities,” researchers said.

Reference:
Baum SG, Coan LM, Porter AK. Meeting the needs of rural veterans through rapid implementation of pharmacist-provided telehealth management of diabetes during the COVID-19 pandemic. .J Am Pharm Assoc. 2022;S1544-3191(22)00354-5. doi:10.1016/j.japh.2022.10.009