title: Care coordination and telemedicine improves glycaemic control in ethnically diverse veterans with diabetes.
abstract: We conducted a pilot study of a care-coordination programme involving daily monitoring and education of elderly diabetic veterans from different racial/ethnic groups. A telephone-based, in-home messaging device was used for patient monitoring and education. Sixty-nine patients were enrolled in the study and HbA(1c) values were obtained both before and after the telemedicine intervention in 41 of them. The mean HbA(1c) before enrolment was 7.6% and the mean value 9 months later was 7.3% (P = 0.09). The greatest fall in HbA(1c) occurred in African-Americans (0.65%, P = 0.05). The total number of hospital admissions decreased from 31 pre-enrolment to 25 post-enrolment (P = 0.0002). Bed days of care decreased from 368 to 149 (P = 0.0002). Care coordination, facilitated by telemedicine, appeared to improve glycaemic control in veterans with diabetes from diverse ethnic backgrounds, particularly African-Americans. This may reduce health-care resource utilization.
authors: Geriatric Research, Education, and Clinical Center and Research Service, Veterans Affairs Medical Center, Miami, Florida, USA. stuti.dang@va.gov
authors: Stuti
authors: S
authors: Dang
authors: Fangchao
authors: F
authors: Ma
authors: Nicole
authors: N
authors: Nedd
authors: Hermes
authors: H
authors: Florez
authors: Enrique
authors: E
authors: Aguilar
authors: Bernard A
authors: BA
authors: Roos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015190:Blood Glucose Self-Monitoring / Q000379:methods; D003920:Diabetes Mellitus / Q000208:ethnology / Q000628:therapy*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008875:Middle Aged; D010348:Patient Care Team; D010353:Patient Education as Topic / Q000379:methods; D010865:Pilot Projects; D012648:Self Care; D017216:Telemedicine / Q000592:standards*; D014728:Veterans
chemical_list: D006442:Glycated Hemoglobin