Discussion Findings suggest that medically underserved patients with diabetes achieve glycemic benefit following HIT DSME interventions , with dissipating but significant effects at 12 months .
Telemedicine/telehealth interventions were the most successful HIT type because they incorporated interaction with educators similar to in-person DSME .
Conclusion These results are similar to in-person DSME in medically underserved patients , showing that well- design ed HIT DSME has the potential to increase access and improve outcomes for this vulnerable group
Objective The purpose of this systematic review and meta- analysis was to examine the effect of health information technology ( HIT ) diabetes self-management education ( DSME ) interventions on glycemic control in medically underserved patients .
Inpatient Diabetes Education Is Associated With Less Frequent Hospital Readmission Among Patients With Poor Glycemic Control
OBJECTIVE To explore the relationship between inpatient diabetes education ( IDE ) and hospital readmissions in patients with poorly controlled diabetes . RESEARCH DESIGN AND METHODS Patients with a discharge diagnosis of diabetes ( ICD-9 code 250.x ) and HbA1c > 9 % who were hospitalized between 2008 and 2010 were retrospectively identified . All-cause first readmissions were determined within 30 days and 180 days after discharge . IDE was conducted by a certified diabetes educator or trainee . Relationships between IDE and hospital readmission were analyzed with stepwise backward logistic regression models . RESULTS In all , 2,265 patients were included in the 30-day analysis and 2,069 patients were included in the 180-day analysis . Patients who received IDE had a lower frequency of readmission within 30 days than did those who did not ( 11 vs. 16 % ; P = 0.0001 ) . This relationship persisted after adjustment for sociodemographic and illness-related factors ( odds ratio 0.66 [ 95 % CI 0.51–0.85 ] ; P = 0.001 ) . Medicaid insurance and longer stay were also independent predictors in this model . IDE was also associated with reduced readmissions within 180 days , although the relationship was attenuated . In the final 180-day model , no IDE , African American race , Medicaid or Medicare insurance , longer stay , and lower HbA1c were independently associated with increased hospital readmission . Further analysis determined that higher HbA1c was associated with lower frequency of readmission only among patients who received a diabetes education consult . CONCLUSIONS Formal IDE was independently associated with a lower frequency of all-cause hospital readmission within 30 days ; this relationship was attenuated by 180 days . Prospect i ve studies are needed to confirm this association
Discussion Findings suggest that medically underserved patients with diabetes achieve glycemic benefit following HIT DSME interventions , with dissipating but significant effects at 12 months .
Telemedicine/telehealth interventions were the most successful HIT type because they incorporated interaction with educators similar to in-person DSME .
Conclusion These results are similar to in-person DSME in medically underserved patients , showing that well- design ed HIT DSME has the potential to increase access and improve outcomes for this vulnerable group
Objective The purpose of this systematic review and meta- analysis was to examine the effect of health information technology ( HIT ) diabetes self-management education ( DSME ) interventions on glycemic control in medically underserved patients .