JMIR Publications

ABSTRACT

Background:

Diabetes is the most expensive chronic condition in the United States. Several barriers of self-monitoring of blood glucose or continuous glucose monitoring have been reported. Remote patient monitoring with appropriate support has potential to give the solutions.

Objective:

To characterize Medicaid diabetic patient adherence to daily remote patient monitoring and investigate blood glucose changes associate with the monitoring service.

Methods:

This study targeted Texas Medicaid patients with diabetes. 180 days of blood glucose data from a remote patient monitoring company were analyzed to assess transmission rates and blood glucose changes. The first 30 days of data were excluded due to startup effects. Patients were separated into adherent and non-adherent cohorts, where adherent patients transmitted data on at least 80% of days. z- and t-tests were performed to compare transmission rates and blood glucose changes between two cohorts.

Results:

Mean patient age was 70.5 (SD 11.8), with 66.8% female, 91.9% urban, and 89% from south Texas (n=382). The adherent cohort (n=186, 48.7%) had a mean transmission rate of 82.8% before the adherence call and 91.1% after. The non-adherent cohort (n=196, 51.3%) had a mean transmission rate of 45.9% before and 60.2% after. The mean blood glucose levels of the adherent cohort decreased by an average of 9 mg/dL (P=.002) over 5 months.

Conclusions:

About half of the Medicaid patients were adherent to remote patient monitoring and they saw significant improvement in blood glucose values. The adherence call intervention was important in helping patients consistently follow daily monitoring protocols.