Predictors of Follow-Up Appointment No-Shows Before and During COVID Among Adults with Type 2 Diabetes

Sun, Chun-An; Perrin, Nancy; Maruthur, Nisa M.; Renda, Susan; Levin, Scott R.; Han, Hae-Ra

doi:10.1089/tmj.2022.0377

Cited by 4 publications

(7 citation statements)

References 40 publications

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“…in their study, sun et al found that hba 1C testing was performed 3 months later than the recommended time, and cancellation of referrals was more common during CoVid-19 than before. in addition, fewer referrals of diabetic patients was not a reason for poor blood sugar control [28]. however, the present study concluded that the delay in visiting a specialist doctor could cause an increase in hba 1C .…”

Section: Discussioncontrasting

confidence: 48%

Effects of delay in visiting a specialist doctor in type 2 diabetic patients on glycemic control: a retrospective cohort study with a 4-year follow-up

Ghanbari-Jahromi,

Kharazmi,

Bastani

et al. 2023

fmpcr

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Background. diabetic patients' delay in visiting a specialist doctor can have significant effects on blood sugar factors. The present study aimed to determine the effects of delay in visiting a specialist doctor in type 2 diabetic patients on glycaemic factors. Material and methods. The patients' demographic and clinical information included in medical records of 209 type 2 diabetic patients referred to diabetes clinics in shiraz city, south of iran, were analysed using logistic mix-model regression. due to the occurrence of CoVid-19 during the follow-up period, data analyses were done separately before and after the pandemic. Results. The mean age of the patients was 63.47 ± 8.89 years, and 67.94% of the type 2 diabetic patients were female. after CoVid-19, haemoglobin a 1C (hBa 1C ) of the patients who had delays of < 3, 3-6 and > 6 months in referring to a specialist increased by 1.81 (or: 1.12-2.93), 2.56 (or: 1.81-5.56) and 3.69 (or: 1.79-7.63), respectively, compared to the group without delays. in this period, 2-hour Postprandial Glucose (2-hpp) of the patients with delays of 3-6 and > 6 months and the Fasting blood sugar (Fbs) of the patients with delays of > 6 months had a significant increase of 1.92 (or: 1.01-3.65), 2.14 (or: 1.09-4.21) and 2.36 (confidence interval of 95%: 1.27-4.39), respectively, compared to the patients without delays in visits. The above trends had a non-significant increase before CoVid-19, though. Conclusions. healthcare providers should ensure the continuity of providing services to diabetes patients, especially during health crises, by taking appropriate measures.

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Section: Discussioncontrasting

confidence: 48%

Effects of delay in visiting a specialist doctor in type 2 diabetic patients on glycemic control: a retrospective cohort study with a 4-year follow-up

Ghanbari-Jahromi,

Kharazmi,

Bastani

et al. 2023

fmpcr

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“…During the COVID-19 pandemic, diabetes-related HbA 1c and nephropathy monitoring declined and did not recover to the prepandemic volume in the primary care setting [ 49 ]. A gap in timing between HbA 1c measurements was also a risk factor for missed appointments in the diabetes-specific setting [ 17 ]. To ensure care continuity and promote better outcomes, future research is warranted to investigate the ideal balance between in-person and telehealth visits in diabetes care.…”

Section: Discussionmentioning

confidence: 99%

“…The findings for this manuscript were the second part of a multimethod study focusing on missed appointments among adults with T2D. In short, the first part of the study used electronic health records (EHRs) to examine if predictors of missed appointments differ (1) between pre-COVID-19 (January 2019 to March 2020) and COVID-19 (March 2020 to December 2020) periods and (2) by health care delivery modes (in-person or telehealth visits) during COVID-19 among adults with T2D; more information is described elsewhere [ 17 ].…”

Section: Methodsmentioning

confidence: 99%

“…Adults who met the inclusion criteria were identified from the EHR and then were contacted via emails, phone calls, or text messages. We used purposive sampling with maximum variation to include adults from different physicians and NPs with diverse characteristics (eg, age [<60 years old, 61-75 years old, >75 years old], sex [female, male], race/ethnicity [Black, White, other], health care delivery modes [in-person or telehealth visits]) based on our quantitative results [ 17 ].…”

Section: Methodsmentioning

confidence: 99%

“…Specific to diabetes care, the transformation from in-person to telehealth visits has the potential to democratize routine diabetes care provision, such as providing care to those with limited transportation who otherwise could not be at the clinic regularly [ 15 , 16 ]. A previous study found that telehealth visits reduced the odds of missed appointments by more than 50% among adults with T2D, compared with in-person visits [ 17 ]. Telehealth visits also addressed some barriers (eg, better access to appointments, shorter travel time) of in-person visits in a group of veterans with T2D living in rural areas before COVID-19 [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

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Experiences and Perceptions of Telehealth Visits in Diabetes Care During and After the COVID-19 Pandemic Among Adults With Type 2 Diabetes and Their Providers: Qualitative Study

Sun,

Shenk,

Renda

et al. 2023

JMIR Diabetes

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Background Since the COVID-19 pandemic, telehealth has been widely adopted in outpatient settings in the United States. Although telehealth visits are publicly accepted in different settings, little is known about the situation after the wide adoption of telehealth from the perspectives of adults with type 2 diabetes mellitus (T2D) and their providers. Objective This study aims to identify barriers and facilitators of maintaining continuity of care using telehealth for patients with T2D in a diabetes specialty clinic. Methods As the second phase of a multimethod study to understand missed appointments among adults with T2D, we conducted semistructured, individual, in-depth phone or Zoom interviews with 23 adults with T2D (14/23, 61% women; mean age 55.1, SD 14.4, range 35-77 years) and 10 providers from diabetes clinics in a tertiary academic medical center in Maryland. Interviews were audio-recorded, transcribed, and analyzed using thematic content analysis by the research team. Results Adults with T2D and their providers generally reported positive experiences with telehealth visits for diabetes care with some technical challenges resulting in the need for in-person visits. We identified the following 3 themes: (1) “perceived benefits of telehealth visits,” such as convenience, time and financial efficiencies, and independence from caregivers, benefits shared by both patients and providers; (2) “perceived technological challenges of telehealth visits,” such as disparities in digital health literacy, frustration caused by unstable internet connection, and difficulty sharing glucose data, challenges shared by both patients and providers; and (3) “impact of telehealth visits on the quality of diabetes care,” including lack of diabetes quality measures and needs and preferences for in-person visits, shared mainly from providers’ perspectives with some patient input. Conclusions Telehealth is generally received positively in diabetes care with some persistent challenges that might compromise the quality of diabetes care. Telehealth technology and glucose data platforms must incorporate user experience and user-centered design to optimize telehealth use in diabetes care. Clinical practices need to consider new workflows for telehealth visits to facilitate easier follow-up scheduling and lab completion. Future research to investigate the ideal balance between in-person and telehealth visits in diabetes care is warranted to enhance the quality of diabetes care and to optimize diabetes outcomes. Policy flexibilities should also be considered to broaden access to diabetes care for all patients with T2D.

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Effectiveness of telehealth versus in-person care during the COVID-19 pandemic: a systematic review

Hatef,

Wilson,

Zhang

et al. 2024

npj Digit. Med.

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In this systematic review, we compared the effectiveness of telehealth with in-person care during the pandemic using PubMed, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials from March 2020 to April 2023. We included English-language, U.S.-healthcare relevant studies comparing telehealth with in-person care conducted after the onset of the pandemic. Two reviewers independently screened search results, serially extracted data, and independently assessed the risk of bias and strength of evidence. We identified 77 studies, the majority of which (47, 61%) were judged to have a serious or high risk of bias. Differences, if any, in healthcare utilization and clinical outcomes between in-person and telehealth care were generally small and/or not clinically meaningful and varied across the type of outcome and clinical area. For process outcomes, there was a mostly lower rate of missed visits and changes in therapy/medication and higher rates of therapy/medication adherence among patients receiving an initial telehealth visit compared with those receiving in-person care. However, the rates of up-to-date labs/paraclinical assessment were also lower among patients receiving an initial telehealth visit compared with those receiving in-person care. Most studies lacked a standardized approach to assessing outcomes. While we refrain from making an overall conclusion about the performance of telehealth versus in-person visits the use of telehealth is comparable to in-person care across a variety of outcomes and clinical areas. As we transition through the COVID-19 era, models for integrating telehealth with traditional care become increasingly important, and ongoing evaluations of telehealth will be particularly valuable.

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Predictors of Follow-Up Appointment No-Shows Before and During COVID Among Adults with Type 2 Diabetes

Cited by 4 publications

References 40 publications

Effects of delay in visiting a specialist doctor in type 2 diabetic patients on glycemic control: a retrospective cohort study with a 4-year follow-up

Effects of delay in visiting a specialist doctor in type 2 diabetic patients on glycemic control: a retrospective cohort study with a 4-year follow-up

Experiences and Perceptions of Telehealth Visits in Diabetes Care During and After the COVID-19 Pandemic Among Adults With Type 2 Diabetes and Their Providers: Qualitative Study

Effectiveness of telehealth versus in-person care during the COVID-19 pandemic: a systematic review

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