Kate Johnson

May 24, 2012

May 24, 2012 (Philadelphia, Pennsylvania) — Telemedicine is an acceptable way to deliver care to endocrinology patients in rural areas, according to a study reported here at the American Association of Clinical Endocrinologists 21st Annual Meeting and Clinical Congress.

"There is an increased prevalence of diabetes in rural compared with urban areas, which is compounded by the problem of a lack of endocrinologists," said Rabia A. Rehman, MD, an endocrinology fellow at the University of Tennessee Health Science Center in Memphis.

"Patients have to travel hundreds of miles to meet a specialist and wait up to 6 months for an appointment. We think this gap can be bridged with telemedicine," she said in a press conference.

The study involved 66 patients (mean age, 53.8 years) from 5 rural areas in Tennessee who were referred by their primary care providers to the telemedicine unit of the University of Tennessee over a period of 2.5 years.

Almost three quarters of the cohort (73%) was female, 35 (53%) had type 2 diabetes, 27 (41%) had hypertension, 30 (45%) had dyslipidemia, 20 (30%) had thyroid disease, and 8 (12%) had osteoporosis or hypercalcemia.

For some patients who had more than 1 endocrine disorder, other consultations included hyponatremia and polycystic ovarian syndrome.

Patients were interviewed and examined using video conferencing in the telemedicine studio, explained Dr. Rehman.

"There is a nurse present with the patient at the remote site who can not only take vital signs, but who can help the physician with some basic physical exam maneuvers, like swelling in the legs or thyroid exams."

Laboratory tests and management strategies were sent to the patients' primary care physicians, who then continued the follow-up.

In 85% of 20 diabetic patients, there was significant improvement at 6 months, compared with baseline, with glycated hemoglobin (HbA1c) decreasing from 9.1% to 7.5 % (P < .002), said Dr. Rehman.

Four patients with thyroid disease became euthyroid over the follow-up period, and 70% of subjects with dyslipidemia showed improved lipid profiles.

Nearly all patients (97%) were comfortable receiving care through video conferencing, she said.

"We think it may be a little costly to set up the equipment up front. However, in the long-run, this will be cost effective, not only for the patients but for overall healthcare," she said. "This will save patients from traveling long distances, resulting in timely consultation and leading to better control. Improvement of HbA1c will also result in prevention of the multiple morbidities and complications that result from uncontrolled diabetes."

Dr. Rehman has disclosed no relevant financial relationships.

American Association of Clinical Endocrinologists (AACE) 21st Annual Meeting and Clinical Congress: Abstract 253. Presented May 24, 2012.


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