by Jill Pease, University of Florida

Reasons for using telehealth services among US adults with diabetes who used telehealth services in 2022, by modality. Credit: BMJ Open (2024). DOI: 10.1136/bmjopen-2024-086418

A University of Florida study finds that people with diabetes who participate in telehealth doctor visits report the same level of quality of care, trust in the health care system, and patient-centered communication as patients who receive care through in-person visits.

The study suggests that telehealth, which exploded in popularity during the early phases of the COVID-19 pandemic, should continue to be integrated into diabetes care, says the study's lead author Young-Rock Hong, Ph.D., M.P.H., an assistant professor in the UF College of Public Health and Health Professions' Department of Health Services Research, Management and Policy.

"Many patients and providers have experienced the convenience and effectiveness of telehealth, not only for diabetes management," Hong said. "The COVID-19 emergency period greatly expanded telehealth access and reimbursement, however, many of these flexibilities are set to expire after the public health emergency ends on Dec. 31, 2024, which could limit telehealth availability without further action."

According to the team's findings, which are published in the journal BMJ Open, about half of patients with Type 1 or Type 2 diabetes use telehealth for their care.

Diabetes care is a particularly good fit for telehealth given the frequency of health care visits—including a recommended four times a year with an endocrinologist—and the focus on lifestyle counseling, medication adjustments, and mental health support, Hong said.

"Telehealth removes barriers, such as distance from the provider, and increases the ease and convenience for receiving diabetes care," added Ashby Walker, Ph.D., the study's senior author, a UF PHHP assistant professor of health services research, management and policy, and the director for health equity initiatives at the UF Diabetes Institute. "Diabetes is a '24–7' disease that impacts people every moment of every day."

Telehealth appears to be a good option from the providers' perspective as well. A previous study team members conducted found more than 80% of U.S. physicians intended to continue telehealth beyond the pandemic.

For the current study, researchers analyzed data from the 2022 Health Information National Trends Survey, a nationally representative survey sponsored by the National Cancer Institute that collects information on health communication and knowledge on all health conditions. Among people with either Type 1 or Type 2 diabetes who completed the survey, telehealth users were more likely to be younger, female, have higher household incomes, have health insurance, and live in metro areas compared with people with diabetes who do not use telehealth.

While telehealth has helped to make care more accessible for people living in rural areas, gaps remain, Hong said.

"Rural areas often lack the necessary broadband infrastructure for reliable video telehealth visits, and these populations have lower levels of digital literacy, making it harder to adopt telehealth technologies," he said. "Addressing these ongoing rural-urban disparities will be crucial to ensure equitable access to health care services, particularly for rural patients with diabetes who often face greater challenges in accessing specialized care."

The researchers hope their findings may influence telehealth policy decisions to extend the flexibilities put in place during the COVID-19 public health emergency period. For example, Hong said, without action, restrictions on the geographic location of patient or provider may be reinstated and payment rates for telehealth services may revert to a lower rate.

"Long-term popularity of telehealth will depend on ongoing policy support, reimbursement structures, and how well it's integrated into routine diabetes care practices," Hong said.

More information: Young-Rock Hong et al, Telehealth service use and quality of care among US adults with diabetes: A cross-sectional study of the 2022 health information national trends survey, BMJ Open (2024). DOI: 10.1136/bmjopen-2024-086418

Journal information: BMJ Open 

Provided by University of Florida