Sunday, April 28, 2024
4/28/2024
PROJECT ABSTRACT Use of telemedicine to deliver specialty care to adults with type 2 diabetes (T2D) has increased rapidly in the last 3 years and persists as a means to enhance access to care for many patients who face barriers to in- person care, such as those in rural areas, or with limited mobility or transportation. However, evidence suggests that telemedicine is less effective than in-person care for patients with complex T2D, including those who use multiple daily injections of insulin and have multiple comorbid conditions. Endocrinologists report that components of high-quality care, including diabetes self-management education and home blood glucose data sharing, are more difficult to deliver via telemedicine. Barriers to delivery of high-quality care can have greater impact on adults with complex T2D, whose disease is already more difficult to manage and who are at higher risk of diabetes-related complications and mortality. Therefore, current gaps in diabetes care quality between in-person and telemedicine care for adults with complex T2D must be characterized and addressed in order for expanded access to care via telemedicine to translate into improved diabetes outcomes for all patients, especially those at highest risk. This K23 award will support the health services research career development of endocrinologist Margaret Zupa, MD MS. Dr. Zupa will use data from a large integrated health system to inform design of a pragmatic intervention to deliver high-quality care to adults with complex T2D via telemedicine through the following specific aims: Aim 1) Characterize gaps in delivery of high-quality care elements via telemedicine for adults with complex T2D. Aim 2) Leverage patient and provider perspectives to develop an intervention to deliver high-quality diabetes telemedicine care for adults with complex T2D. Aim 3) Determine feasibility and preliminary outcomes of a pragmatic intervention to provide high-quality diabetes telemedicine care for adults with complex T2D. With the knowledge gained in these aims, Dr. Zupa will develop an approach to improve care quality and clinical outcomes for adults with T2D who are at high risk of adverse diabetes outcomes and rely on telemedicine to access care. Dr. Zupa has developed a thorough training and mentoring plan which aligns with the above research. She will build skills in advanced quantitative modeling of care pathways and outcomes, pragmatic clinical trial design, and application of implementation science mixed methods to healthcare delivery. An experienced, multidisciplinary team of mentors with a strong track record of impactful diabetes and virtual care research is committed to supporting Dr. Zupa in achieving these career development and research goals and in progressing to independence as a health services researcher. This mentored research and training will lead to the development of a future hybrid effectiveness-implementation randomized trial to evaluate the impact of this intervention on clinical, patient-centered, and quality outcomes.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).
