Remote Patient Monitoring and Clinical Outcomes for Postdischarge Patients with Type 2 Diabetes

Tzeyu L. Michaud, Mohammad Siahpush, Robert J. Schwab, Leslie A. Eiland, Mary Devany, Geri Hansen, Tammy S. Slachetka, Eugene Boilesen, Hyo Jung Tak, Fernando A. Wilson, Hongmei Wang, Jose Pagan, Dejun Su

Research output: Contribution to journalArticle

Abstract

The objective of this study was to evaluate changes in clinical outcomes for patients with type 2 diabetes (T2D) after a 3-month remote patient monitoring (RPM) program, and examine the relationship between hemoglobin A1c (HbA1c) outcomes and participant characteristics. The study sample included 955 patients with T2D who were admitted to an urban Midwestern medical center for any reason from 2014 to 2017, and used RPM for 3 months after discharge. Clinical outcomes included HbA1c, weight, body mass index (BMI), and patient activation scores. Logistic regression was used to estimate the likelihood of having a postintervention HbA1c <9% by patient characteristics, among those who had baseline HbA1c >9%. Most patients experienced decreases in HbA1c (67%) and BMI (58%), and increases in patient activation scores (67%) (P < 0.001 in all 3 cases) at the end of RPM. Logistic regression analyses revealed that among patients who had HbA1c >9% at baseline, men (odds ratio [OR] = 3.72; 95% confidence interval [CI], 1.43-9.64), those who had increased patient activation scores after intervention (OR = 1.05; 95% CI, 1.01-1.09), those who had higher baseline patient activation scores, and those who had a greater number of biometric data uploads during the intervention (OR = 1.02; 95% CI, 1.00-1.04) were more likely to have reduced their HbA1c to <9% at the end of RPM. RPM for postdischarge patients with T2D might be a promising approach for HbA1c control with increased patient engagement. Future studies with study designs that include a control group should provide more robust evidence.

Original languageEnglish (US)
Pages (from-to)387-394
Number of pages8
JournalPopulation Health Management
Volume21
Issue number5
DOIs
StatePublished - Oct 1 2018

Fingerprint

Patient Participation
Physiologic Monitoring
Type 2 Diabetes Mellitus
Hemoglobins
Odds Ratio
Confidence Intervals
Body Mass Index
Logistic Models
Weights and Measures
Control Groups

Keywords

  • disease management
  • HbA1c
  • patient activation
  • telehealth
  • telemedicine

ASJC Scopus subject areas

  • Leadership and Management
  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

Michaud, T. L., Siahpush, M., Schwab, R. J., Eiland, L. A., Devany, M., Hansen, G., ... Su, D. (2018). Remote Patient Monitoring and Clinical Outcomes for Postdischarge Patients with Type 2 Diabetes. Population Health Management, 21(5), 387-394. https://doi.org/10.1089/pop.2017.0175

Remote Patient Monitoring and Clinical Outcomes for Postdischarge Patients with Type 2 Diabetes. / Michaud, Tzeyu L.; Siahpush, Mohammad; Schwab, Robert J.; Eiland, Leslie A.; Devany, Mary; Hansen, Geri; Slachetka, Tammy S.; Boilesen, Eugene; Tak, Hyo Jung; Wilson, Fernando A.; Wang, Hongmei; Pagan, Jose; Su, Dejun.

In: Population Health Management, Vol. 21, No. 5, 01.10.2018, p. 387-394.

Research output: Contribution to journalArticle

Michaud, TL, Siahpush, M, Schwab, RJ, Eiland, LA, Devany, M, Hansen, G, Slachetka, TS, Boilesen, E, Tak, HJ, Wilson, FA, Wang, H, Pagan, J & Su, D 2018, 'Remote Patient Monitoring and Clinical Outcomes for Postdischarge Patients with Type 2 Diabetes', Population Health Management, vol. 21, no. 5, pp. 387-394. https://doi.org/10.1089/pop.2017.0175
Michaud, Tzeyu L. ; Siahpush, Mohammad ; Schwab, Robert J. ; Eiland, Leslie A. ; Devany, Mary ; Hansen, Geri ; Slachetka, Tammy S. ; Boilesen, Eugene ; Tak, Hyo Jung ; Wilson, Fernando A. ; Wang, Hongmei ; Pagan, Jose ; Su, Dejun. / Remote Patient Monitoring and Clinical Outcomes for Postdischarge Patients with Type 2 Diabetes. In: Population Health Management. 2018 ; Vol. 21, No. 5. pp. 387-394.
@article{29644b13cbef4a008b12f3772adfdee9,
title = "Remote Patient Monitoring and Clinical Outcomes for Postdischarge Patients with Type 2 Diabetes",
abstract = "The objective of this study was to evaluate changes in clinical outcomes for patients with type 2 diabetes (T2D) after a 3-month remote patient monitoring (RPM) program, and examine the relationship between hemoglobin A1c (HbA1c) outcomes and participant characteristics. The study sample included 955 patients with T2D who were admitted to an urban Midwestern medical center for any reason from 2014 to 2017, and used RPM for 3 months after discharge. Clinical outcomes included HbA1c, weight, body mass index (BMI), and patient activation scores. Logistic regression was used to estimate the likelihood of having a postintervention HbA1c <9{\%} by patient characteristics, among those who had baseline HbA1c >9{\%}. Most patients experienced decreases in HbA1c (67{\%}) and BMI (58{\%}), and increases in patient activation scores (67{\%}) (P < 0.001 in all 3 cases) at the end of RPM. Logistic regression analyses revealed that among patients who had HbA1c >9{\%} at baseline, men (odds ratio [OR] = 3.72; 95{\%} confidence interval [CI], 1.43-9.64), those who had increased patient activation scores after intervention (OR = 1.05; 95{\%} CI, 1.01-1.09), those who had higher baseline patient activation scores, and those who had a greater number of biometric data uploads during the intervention (OR = 1.02; 95{\%} CI, 1.00-1.04) were more likely to have reduced their HbA1c to <9{\%} at the end of RPM. RPM for postdischarge patients with T2D might be a promising approach for HbA1c control with increased patient engagement. Future studies with study designs that include a control group should provide more robust evidence.",
keywords = "disease management, HbA1c, patient activation, telehealth, telemedicine",
author = "Michaud, {Tzeyu L.} and Mohammad Siahpush and Schwab, {Robert J.} and Eiland, {Leslie A.} and Mary Devany and Geri Hansen and Slachetka, {Tammy S.} and Eugene Boilesen and Tak, {Hyo Jung} and Wilson, {Fernando A.} and Hongmei Wang and Jose Pagan and Dejun Su",
year = "2018",
month = "10",
day = "1",
doi = "10.1089/pop.2017.0175",
language = "English (US)",
volume = "21",
pages = "387--394",
journal = "Population Health Management",
issn = "1942-7891",
publisher = "Mary Ann Liebert Inc.",
number = "5",

}

TY - JOUR

T1 - Remote Patient Monitoring and Clinical Outcomes for Postdischarge Patients with Type 2 Diabetes

AU - Michaud, Tzeyu L.

AU - Siahpush, Mohammad

AU - Schwab, Robert J.

AU - Eiland, Leslie A.

AU - Devany, Mary

AU - Hansen, Geri

AU - Slachetka, Tammy S.

AU - Boilesen, Eugene

AU - Tak, Hyo Jung

AU - Wilson, Fernando A.

AU - Wang, Hongmei

AU - Pagan, Jose

AU - Su, Dejun

PY - 2018/10/1

Y1 - 2018/10/1

N2 - The objective of this study was to evaluate changes in clinical outcomes for patients with type 2 diabetes (T2D) after a 3-month remote patient monitoring (RPM) program, and examine the relationship between hemoglobin A1c (HbA1c) outcomes and participant characteristics. The study sample included 955 patients with T2D who were admitted to an urban Midwestern medical center for any reason from 2014 to 2017, and used RPM for 3 months after discharge. Clinical outcomes included HbA1c, weight, body mass index (BMI), and patient activation scores. Logistic regression was used to estimate the likelihood of having a postintervention HbA1c <9% by patient characteristics, among those who had baseline HbA1c >9%. Most patients experienced decreases in HbA1c (67%) and BMI (58%), and increases in patient activation scores (67%) (P < 0.001 in all 3 cases) at the end of RPM. Logistic regression analyses revealed that among patients who had HbA1c >9% at baseline, men (odds ratio [OR] = 3.72; 95% confidence interval [CI], 1.43-9.64), those who had increased patient activation scores after intervention (OR = 1.05; 95% CI, 1.01-1.09), those who had higher baseline patient activation scores, and those who had a greater number of biometric data uploads during the intervention (OR = 1.02; 95% CI, 1.00-1.04) were more likely to have reduced their HbA1c to <9% at the end of RPM. RPM for postdischarge patients with T2D might be a promising approach for HbA1c control with increased patient engagement. Future studies with study designs that include a control group should provide more robust evidence.

AB - The objective of this study was to evaluate changes in clinical outcomes for patients with type 2 diabetes (T2D) after a 3-month remote patient monitoring (RPM) program, and examine the relationship between hemoglobin A1c (HbA1c) outcomes and participant characteristics. The study sample included 955 patients with T2D who were admitted to an urban Midwestern medical center for any reason from 2014 to 2017, and used RPM for 3 months after discharge. Clinical outcomes included HbA1c, weight, body mass index (BMI), and patient activation scores. Logistic regression was used to estimate the likelihood of having a postintervention HbA1c <9% by patient characteristics, among those who had baseline HbA1c >9%. Most patients experienced decreases in HbA1c (67%) and BMI (58%), and increases in patient activation scores (67%) (P < 0.001 in all 3 cases) at the end of RPM. Logistic regression analyses revealed that among patients who had HbA1c >9% at baseline, men (odds ratio [OR] = 3.72; 95% confidence interval [CI], 1.43-9.64), those who had increased patient activation scores after intervention (OR = 1.05; 95% CI, 1.01-1.09), those who had higher baseline patient activation scores, and those who had a greater number of biometric data uploads during the intervention (OR = 1.02; 95% CI, 1.00-1.04) were more likely to have reduced their HbA1c to <9% at the end of RPM. RPM for postdischarge patients with T2D might be a promising approach for HbA1c control with increased patient engagement. Future studies with study designs that include a control group should provide more robust evidence.

KW - disease management

KW - HbA1c

KW - patient activation

KW - telehealth

KW - telemedicine

UR - http://www.scopus.com/inward/record.url?scp=85054673567&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85054673567&partnerID=8YFLogxK

U2 - 10.1089/pop.2017.0175

DO - 10.1089/pop.2017.0175

M3 - Article

C2 - 29583057

AN - SCOPUS:85054673567

VL - 21

SP - 387

EP - 394

JO - Population Health Management

JF - Population Health Management

SN - 1942-7891

IS - 5

ER -