Utilizing clinical video telehealth to improve access and optimize pharmacists' role in diabetes management.

OBJECTIVES: To evaluate whether clinical pharmacy specialist (CPS) services delivered using clinical video telehealth (CVT) is consistent with CPS services via face-to-face (FTF) visits in a cohort of patients with poorly controlled type 2 diabetes mellitus. In addition, the study aimed to evaluate the potential benefits for the patient with implementation of CVT services.

METHODS: Single-center retrospective cohort study. FTF services provided at a single community-based outpatient clinic (CBOC). CVT services provided at a main campus targeting the same CBOC. Patients with type 2 diabetes mellitus (A1c > 7%) consulted for management by a CPS between April 2013 and October 2014 were included. The primary outcome was mean A1c reduction at 3 and 6 months. Secondary outcomes included time from consult placement to visit, average travel distance averted, and average travel time averted.

RESULTS: Mean A1c reduction at 3 months was 1.096 ± 1.8 for FTF services before CVT (P ≤ 0.0001), 1.839 ± 1.7 for FTF services after CVT (P ≤ 0.0001), and 2.262 ± 2.8 (P = 0.0004) for CVT services. At 6 months, the mean A1c reduction was 1.202 ± 1.9 (P ≤ 0.0001), 1.965 ± 2 (P ≤ 0.0001), and 2.610 ± 3.8 (P = 0.0004). At 6 months there was no statistical difference between groups. The average time in days from consult placement to initial visit decreased from 106.3 ± 24.5 to 46 ± 35.3 (P ≤ 0.0001). The average travel distance in miles averted per patient was 99.5 ± 20.3, and the average travel time in hours averted was 1.6 ± 0.3.

CONCLUSIONS: Diabetes care provided by a CPS via CVT was as effective for the management of type 2 diabetes compared to FTF management by a CPS. Implementation of telehealth services increased access to providers as shown by the reduction in time from consult placement until initial visit.