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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