Diabetes administration amongst underserved older adults by telemedicine and group well being staff

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This article was originally published here

J Am Assoc Nurse Pract. 2021 April 7th doi: 10.1097 / JXX.0000000000000595. Online before printing.

ABSTRACT

BACKGROUND: Diabetes mellitus (DM) disproportionately affects older adults from marginalized communities. In the United States, the prevalence of DM at age 65 or older is twice the national average for adult populations. Telemedicine and community health workers (CHWs) are emerging models for diabetes care, but their effects on older adults with limited resources are relatively neglected in the medical literature.

OBJECTIVES: The aim of this systematic review was to investigate the effects of telemedicine and CHW interventions on improving A1C scores and self-management behavior in underserved older adults with DM.

DATA SOURCES: A systematic literature search was conducted in PubMed, CINAHL, Embase and Cochrane databases, using the preferred reporting elements for systematic reviews and meta-analyzes as reporting guidelines.

CONCLUSIONS: Diabetes Self-Management (DSME) education through telemedicine and CHW interventions was effective in improving A1C scores, adherence to self-care, and patient and care provider satisfaction among adults aged 50 and over. Common barriers to diabetes care are insufficient resources, lack of transportation, inconsistent means of communication, social isolation, and low motivation. Community health workers and telemedicine have been effective in improving disease management and optimizing care coordination within the vulnerable adult population.

PRACTICE IMPACT: Well-coordinated, evidence-based, and population-centered interventions can overcome the unique differences that exist among underserved older adults with diabetes. By including DSME-controlled telemedicine and CHW interventions in basic care, diabetes-related complications in older population groups can be reduced. The lack of specific evidence for adults ≥ 65 years of age requires a generally accepted age range when referring to older adults in future research.

PMID: 33859074 | DOI: 10.1097 / JXX.0000000000000595