Patient and supporter factors affecting engagement with diabetes telehealth.
Patient and supporter factors affecting engagement with diabetes telehealth.
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DOI：
10.37765/ajmc.2021.88758
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发表时间：
2021-10
期刊：
影响因子：
--
通讯作者：
Rosland AM
中科院分区：
文献类型：
--
作者：
Zupa MF;Piette JD;Stoll SC;Obrosky DS;Boudreaux-Kelly M;Youk AO;Overholt L;Trivedi R;Heisler M;Rosland AM
评估患者、家庭支持者和呼叫特征预测患者在远程健康糖尿病干预中是否完成自动呼叫和教练提供的呼叫。123名患有2型糖尿病和高HbA1c或高血压的成年人，在家庭支持者的登记下，在12个月的时间里接受了自动交互语音应答(IVR)和教练提供的探视准备电话。来自基线调查的数据和来自患者医疗记录的糖尿病相关临床信息被输入参与者和呼叫特征与呼叫完成之间的关联的多级别多变量回归模型。2784个IVR呼叫中的76.3%和367个访问准备呼叫中的75.8%完成。对于IVR呼叫，最近呼叫触发提供商警报的患者呼叫完成的几率更高(AOR 3.5，95%CI(2.2，5.5))；那些有抑郁症状的患者(AOR 0.4(0.2，0.9))，更高的HbA1c(AOR 0.8(0.6，0.99))，以及研究中的更多月(AOR 0.9(0.87，0.94)/月)有更低的几率。对于访问准备呼叫，患者激活分数越高，呼叫完成率越高(AOR 1.4(1.1，1.9))；患者大学教育程度预测呼叫完成率较低(AOR 0.3(0.2，0.6))。服用药物的支持者帮助预测这两种呼叫类型的完成率较低。患者年龄不能预测呼叫完成率。所有年龄段的患者完成远程医疗呼叫的比率都很高。当向患者的提供者发现紧急问题时，自动IVR呼叫完成的频率更高，但如果患者有高HbA1c或抑郁，则完成自动IVR呼叫的频率较低。就诊准备拜访的内容应根据患者的教育水平量身定制。家庭对药物的帮助可能会确定需要额外支持的患者，以参与远程医疗。家庭对药物管理的支持和最近紧急的自我管理关注是预测糖尿病远程医疗呼叫完成的两个新因素。
Assess what patient, family supporter and call characteristics predicted whether patients completed automated and coach-provided calls in a telehealth diabetes intervention. 123 adults with type 2 diabetes and high HbA1c or blood pressure, enrolled with a family supporter, received automated interactive voice-response (IVR) and coach-provided visit preparation calls over 12 months. Data from baseline surveys and diabetes-related clinical information from patient medical records was entered into multilevel multivariate regression models of associations between participant and call characteristics with call completion. 76.3% of 2,784 IVR calls and 75.8% of 367 visit preparation calls were completed. For IVR calls, patients with recent call-triggered provider alerts had higher odds of call completion (AOR 3.5, 95%CI (2.2,5.5)); those with depressive symptoms (AOR 0.4 (0.2,0.9)), higher HbA1c (AOR 0.8 (0.6,0.99)), and more months in the study (AOR 0.9 (0.87,0.94) per month) had lower odds. For visit preparation calls, higher patient activation scores predicted higher call completion (AOR 1.4 (1.1,1.9)); patient college education predicted less call completion (AOR 0.3 (0.2,0.6)). Supporter help taking medications predicted less completion of both call types. Patient age did not predict call completion. Patients of all ages completed telehealth calls at a high rate. Automated IVR calls were completed more often when urgent issues were identified to patients’ providers, but less often if patients had high HbA1c or depression. Visit preparation call content should be tailored to patient education level. Family help with medications may identify patients needing additional support to engage with telehealth. Family support with medication management and recent urgent self-management concerns are two novel factors, among others, which predict completion of diabetes telehealth calls.
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影响因子：
16.2
作者：
Piette, JD;McPhee, SJ;Kraemer, FB
通讯作者：
Kraemer, FB
影响因子：
3.5
作者：
Ten Klooster, Peter M.;Oostveen, Johanna C. M.;van de Laar, Mart A. F. J.
通讯作者：
van de Laar, Mart A. F. J.
影响因子：
5.7
作者：
Chew, Lisa D.;Griffin, Joan M.;VanRyn, Michelle
通讯作者：
VanRyn, Michelle
影响因子：
2.5
作者：
Rosland AM;Piette JD;Trivedi R;Kerr EA;Stoll S;Tremblay A;Heisler M
通讯作者：
Heisler M
影响因子：
3
作者：
Piette JD;Rosland AM;Marinec NS;Striplin D;Bernstein SJ;Silveira MJ
通讯作者：
Silveira MJ