Diabetes Remote Patient Monitoring (RPM) & Education in a Rural Setting

POSTER

Diabetes Remote Patient Monitoring (RPM) & Education in a Rural Setting AnneMarie Rousseau, BSN, RN, CDCES, DNP-FNP Student and Nancy A. Allen, PhD, ANP-BC Key Findings: This QI project focused on the process of creating a diabetes RPM program then trialing it with a small sample of individuals to determine if it was feasible, usable, and if participants were satisfied. At the conclusion of the six-week intervention, key findings included high retention rate and high levels of participation. More study in a larger sample is needed to determine if the RPM program can improve glycemic and psychosocial outcomes in rural Utah. Background Rural communities experience geographic health disparities RPM allows the diabetes team to remotely access diabetes technology data and provide remote support and education in a rural setting Uintah, Duchesne, and Daggett counties have some of the highest diabetes prevalence rates in Utah with very limited diabetes services Methods RPM QI project to improve access to diabetes education among PWD utilizing insulin pumps Developed a weekly diabetes RPM curriculum using resources from the ADCES7 Self-Care Behaviors and weekly educational videos Weekly insulin pump data reviewed and diabetes education delivered to participants by diabetes team through the Uintah Basin Healthcare (UBH) patient portal Implemented diabetes RPM program over 6 weeks Results Figure 1. RPM Video Topics Week 1: Healthy Coping •Recognizing and managing diabetes burnout Week 2: Healthy Eating • Extended bolus feature • Carb-counting tips for eating out • Holiday eating Week 3: Being Active Week 4: Medication & Monitoring Week 5: Problem Solving Week 6: Reducing Risks Feasibility: • Project provided sufficient value to address problem of geographic health disparities •Temporary basal rates for exercise Usability: • 5 of 6 participants consistently opened weekly patient portal messages • 67 views of six weekly YouTube videos •Rapid-acting insulins •BG targets and HbA1c recommendations Satisfaction: • Diabetes Treatment Satisfaction Questionnaire • Moderately-high to high satisfaction •Diabetes and emergency preparedness •Infusion set troubleshooting •Sick day management • Participants indicated in open-ended feedback survey that the program improved communication and saved travel time and cost •Annual labs; vaccines •Daily foot check •Annual ophthalmologist and podiatrist visits Patient Reported Outcome Measures: • No change in diabetes distress or diabetes knowledge pre- to post-intervention • Limitation: small sample size Table 1. RPM Participant Demographics Characteristic N % Age, years M SD 49.5 ± 11.9 Sex: Female 5 83.3% Measured Type 1 Diabetes Distress and Diabetes Knowledge pre- and post-intervention Race: White 6 100% Diabetes duration, years 15.3 ± 11.2 Evaluated program feasibility, usability, and satisfaction Insulin pump usage, years 1.8 ± 1.6 Type 1 Diabetes 2 33.3% Type 2 Diabetes 4 66.7% Conclusions • Diabetes RPM was useful in providing diabetes education and insulin pump support to PWD in a rural setting • High retention rate indicated high interest after enrollment • Next step is to implement in a larger cohort COLLEGE OF NURSING