Telehealth can provide an attractive alternative to in-person educational and psychosocial support for women with gestational diabetes, according to a presenter at the American Diabetes Association 79th Scientific Sessions.
Women who attended telehealth sessions for gestational diabetes education reported similar gestational diabetes-related knowledge and satisfaction with care as women who received standard in-person care, but they attended more sessions and monitored blood glucose more frequently, according to Harsimran Singh, PhD health psychologist and clinical research scientist at the Mary & Dick Allen Diabetes Center at Hoag Memorial Hospital Presbyterian in Newport Beach, California.
“Women with gestational diabetes generally get diagnosed between 24 to 28 weeks of pregnancy. Pregnancy is normally perceived to be a time of hope, excitement and joy. For patients to suddenly find out that they have a form of diabetes, which could potentially have serious consequences for both them and their unborn baby, comes as a significant shock and disappointment. Anxiety and distress is quite common in our GDM patients, which may delay their engagement in optimal care for their GDM,” Singh told Endocrine Today.
Hoping to alleviate some of the time burden for women, who often have multiple other competing time commitments including lengthy health care appointments during pregnancy, Singh and colleagues developed a “hybrid” telehealth program to deliver gestational diabetes education and psychosocial support. Their program was based of the California Diabetes and Pregnancy Program (CDAPP) – Sweet Success. It featured the same content as their traditional in-person program, which consists of four sessions during pregnancy followed by an additional session after delivery. In the telehealth version, women attend only the first and last sessions in person while the remaining were conducted via live video link with the same care providers.
“These women are very motivated to make recommended changes for their child’s health. That makes our work as healthcare professionals a bit easier than usual,” Singh said. “However, we find that these patients generally have had complicated obstetric histories and are frequently juggling multiple other commitments including work, personal lives, and other health care appointments. In our previous studies, one feedback we definitely received was to present them with alternative options for care delivery instead of time intensive clinic appointments.”
In this pilot program, the researchers randomly assigned 60 ethnically diverse women with newly diagnosed gestational diabetes to the telehealth program or regular care.
In both groups, gestational diabetes knowledge increased significantly from baseline in both groups. No differences were observed between groups in terms of delivery data and other clinical outcomes. However, the telehealth group indicated significantly improved blood glucose monitoring and attendance at appointments. In addition, the total intervention time for women who attended all sessions was significantly shorter for those in the telehealth vs. the in-person group.
“We are pleased to find no clinical differences in the outcomes of the routine care and the telehealth groups,” Singh said. “This allows us to provide alternatives to patients in terms of healthcare delivery and they can decide on what interventions are better suited to their lifestyle without compromising their health.”
“With its increasing prevalence, GDM is a public health concern in the truest sense. The multidisciplinary management of this condition lends itself particularly well to the telehealth intervention — and our study findings support this. I would encourage our health care community to consider this as an option because if this medium helps us improve patient engagement and reduce disease burden, there is significant opportunity in improving these patients’ postpartum care. Our team will be looking at that next.” – by Jill Rollet
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