Identifying the barriers and perceptions of non-Hispanic black and Hispanic/Latino persons with uncontrolled type 2 diabetes for participation in a home Telemonitoring feasibility study: a quantitative analysis of those who declined participation, withdrew or were non-adherent

Tong, Timothy; Myers, Alyson; Bissoonauth, Aditya; Pekmezaris, Renée; Kozikowski, Andrzej

doi:10.1080/13557858.2019.1566520

Cited by 14 publications

(19 citation statements)

References 27 publications

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“…Eight of these agreed to engage in semi-structured interviews about the study. As documented in our previous study, the most common reasons for not completing the study were: disinterest, inconvenience, lack of perceived benefit, lack of awareness of T2D diagnosis, and perceived lack of ability to do the study 19 (Table 5). Other studies have shown the same results as well as other causes for dropping out including: technology issues, irrelevant and incomprehensible content, or preferring face-to-face visits.…”

Section: Discussionmentioning

confidence: 84%

“…Despite the successes of telehealth, there have also been challenges, including: equipment cost, 16 connectivity issues, 17 privacy concerns, 18 lack of perceived benefit by the patient, 19 and the depersonalization of the experience. 20 Another limitation is evidence of efficacy in disparity populations: NHB and H/L patients tend to be underrepresented in telehealth trials despite their higher rates of diabetes.…”

Section: Introductionmentioning

confidence: 99%

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Telemedicine for Disparity Patients With Diabetes: The Feasibility of Utilizing Telehealth in the Management of Uncontrolled Type 2 Diabetes in Black and Hispanic Disparity Patients; A Pilot Study

Myers

Presswala

Bissoonauth

et al. 2020

J Diabetes Sci Technol

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Background: Non-Hispanic Black (NHB) and Hispanic/Latinx (H/L) patients bear a disproportionate burden of type 2 diabetes and associated complications. Regular visits to a primary care doctor or diabetes specialist are warranted to maintain glycemic control, but for a myriad of reasons disparity populations may have difficulties receiving diabetes care. We seek to determine the feasibility of telehealth added to care as usual and secondarily to improve health outcomes (hemoglobin A1c [HbA1c]) in NHB and H/L with uncontrolled type 2 diabetes managed with two or three noninsulin agents. Methods: Twenty-nine patients were randomized to monthly phone calls or weekly to biweekly telehealth visits. Feasibility outcomes were summarized descriptively for the telehealth arm. Differences scores for A1C level and surveys were computed between baseline and three months and compared across arms using a two-sample t test or Mann-Whitney U test. Results: Patients in the telehealth arm completed a median of eight visits (IQR: 5, 8), and 53% of those in the telephone arm completed 100% of their calls. Change in HbA1c was greater for those in the telephone arm (–2.57 vs –2.07%, P = .70) but the mean baseline HbA1c was higher in the telephone group (11.1% vs 10.3%). Although the change in HbA1c was not statistically different across arms, it was clinically significant. Conclusions: Augmenting care as usual with telehealth provided by telephone or tablet can be of benefit in improving glycemic control in NHB and H/L with type 2 diabetes. Larger studies need to explore this further.

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Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Telemedicine for Disparity Patients With Diabetes: The Feasibility of Utilizing Telehealth in the Management of Uncontrolled Type 2 Diabetes in Black and Hispanic Disparity Patients; A Pilot Study

Myers

Presswala

Bissoonauth

et al. 2020

J Diabetes Sci Technol

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“…Moreover, minority and low socioeconomic status populations are historically more distrustful of the healthcare system due to under investigated mechanisms of systemic racism, which can be exacerbated in a major public health crisis [12,13]. These populations, which are already less likely to seek medical care in traditional ways, may be even less likely to choose and trust telemedicine, a more novel avenue of receiving care [14].…”

Section: Introductionmentioning

confidence: 99%

Disparities in telemedicine utilization among surgical patients during COVID-19

et al. 2021

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Background Telemedicine has been rapidly adopted in the wake of the COVID-19 pandemic. There is limited work surrounding demographic and socioeconomic disparities that may exist in telemedicine utilization. This study aimed to examine demographic and socioeconomic differences in surgical patient telemedicine usage during the COVID-19 pandemic. Methods Department of Surgery outpatients seen from July 1, 2019 to May 31, 2020 were stratified into three visit groups: pre-COVID-19 in-person, COVID-19 in-person, or COVID-19 telemedicine. Generalized linear models were used to examine associations of sex, race/ethnicity, Distressed Communities Index (DCI) scores, MyChart activation, and insurance status with telemedicine usage during the COVID-19 pandemic. Results 14,792 patients (median age 60, female [57.0%], non-Hispanic White [76.4%]) contributed to 21,980 visits. Compared to visits before the pandemic, telemedicine visits during COVID-19 were more likely to be with patients from the least socioeconomically distressed communities (OR, 1.31; 95% CI, 1.08,1.58; P = 0.005), with an activated MyChart (OR, 1.38; 95% CI, 1.17–1.64; P < .001), and with non-government or commercial insurance (OR, 2.33; 95% CI, 1.84–2.94; P < .001). Adjusted comparison of telemedicine visits to in person visits during COVID-19 revealed telemedicine users were more likely to be female (OR, 1.38, 95% CI, 1.10–1.73; P = 0.005) and pay with non-government or commercial insurance (OR, 2.77; 95% CI, 1.85–4.16; P < .001). Conclusions During the first three months of the COVID-19 pandemic, telemedicine was more likely utilized by female patients and those without government or commercial insurance compared to patients who used in-person visits. Interventions using telemedicine to improve health care access might consider such differences in utilization.

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Section: Introductionmentioning

confidence: 99%

“…3 In other chronic health conditions, telehealth has been shown to increase access to specialty care among patients who are minorities and those with geographical limitations, but it could also exacerbate health disparities. [4][5][6] The COVID-19 pandemic has highlighted the need for novel ways to care for patients, and has catapulted telehealth to the forefront. 7,8 It has also shed light on the striking societal and racial inequalities that exist across healthcare, including worse access to care and outcomes for minority populations.…”

Section: Introductionmentioning

confidence: 99%

Expanded access to multiple sclerosis teleneurology care following the COVID-19 pandemic

McGinley¹,

Gales

Rowles

et al. 2021

Multiple Sclerosis Journal - Experimental, Translational and Cl

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Background Teleneurology for multiple sclerosis (MS) care was considered feasible, but utilization was limited. Objective To describe how the existing teleneurology populations at two academic MS Centers changed during the COVID-19 pandemic. Methods In this cross-sectional study, we captured all in-person and teleneurology visits at two academic MS Centers between January 2019 and April 2020. We compared group differences between the Centers, and COVID-related changes using T-, chi-squared Kruskal-Wallis and Fisher exact tests. Results 2268 patients completed 2579 teleneurology visits (mean age 48.3 ± 13.3 years, 72.9% female). Pre-COVID, the Centers’ teleneurology populations were similar for age, sex, MS type, and disability level (all p > 0.1), but differed for race (96.5% vs 80.7% white, p ≤ 0.001), MS treatment (49.1% vs 32.1% infusible, p ≤ 0.001), and median distance from Center (72 vs 186 miles, p ≤ 0.001). Post-COVID, both Centers’ teleneurology populations had more black (12.7% vs 4.37%, p ≤ 0.001) and local (median 34.5 vs 102 miles, p ≤ 0.001) patients. Conclusion Teleneurology visits in 2019 reflected the organizational and local teleneurology reimbursement patterns of our Centers. Our post-COVID-19 changes illustrate the potential for payors and policy to change disparities in access to, or utilization of, remote care. Patients’ perception of care quality and value following this shift warrants study.

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Identifying the barriers and perceptions of non-Hispanic black and Hispanic/Latino persons with uncontrolled type 2 diabetes for participation in a home Telemonitoring feasibility study: a quantitative analysis of those who declined participation, withdrew or were non-adherent

Cited by 14 publications

References 27 publications

Telemedicine for Disparity Patients With Diabetes: The Feasibility of Utilizing Telehealth in the Management of Uncontrolled Type 2 Diabetes in Black and Hispanic Disparity Patients; A Pilot Study

Telemedicine for Disparity Patients With Diabetes: The Feasibility of Utilizing Telehealth in the Management of Uncontrolled Type 2 Diabetes in Black and Hispanic Disparity Patients; A Pilot Study

Disparities in telemedicine utilization among surgical patients during COVID-19

Expanded access to multiple sclerosis teleneurology care following the COVID-19 pandemic

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