Your browser doesn't support javascript.
Long-Term Effectiveness of the TIME Intervention to Improve Diabetes Outcomes in Low-Income Settings: a 2-Year Follow-Up.
Vaughan, Elizabeth M; Johnson, Evan; Naik, Aanand D; Amspoker, Amber B; Balasubramanyam, Ashok; Virani, Salim S; Ballantyne, Christie M; Johnston, Craig A; Foreyt, John P.
  • Vaughan EM; Division of Atherosclerosis and Vascular Medicine, Department of Medicine, Baylor College of Medicine (Baylor), Houston, TX, USA. elizabeth.vaughan@bcm.edu.
  • Johnson E; Division of General Internal Medicine, Baylor, Houston, TX, USA. elizabeth.vaughan@bcm.edu.
  • Naik AD; School of Health Professions, Baylor, Houston, TX, USA.
  • Amspoker AB; Houston Center for Innovations in Quality, Effectiveness, and Safety (IQuESt), Houston, TX, USA.
  • Balasubramanyam A; Michael E. DeBakey VA Medical Center, Houston, TX, USA.
  • Virani SS; Houston Center for Innovations in Quality, Effectiveness, and Safety (IQuESt), Houston, TX, USA.
  • Ballantyne CM; Michael E. DeBakey VA Medical Center, Houston, TX, USA.
  • Johnston CA; Division of Diabetes, Endocrinology and Metabolism, Baylor, Houston, TX, USA.
  • Foreyt JP; Division of Atherosclerosis and Vascular Medicine, Department of Medicine, Baylor College of Medicine (Baylor), Houston, TX, USA.
J Gen Intern Med ; 37(12): 3062-3069, 2022 09.
Article in English | MEDLINE | ID: covidwho-1669972
ABSTRACT

BACKGROUND:

We previously found that a 6-month multidimensional diabetes program, TIME (Telehealth-Supported, Integrated Community Health Workers, Medication-Access) resulted in improved clinical outcomes.

OBJECTIVE:

To follow TIME participant clinical outcomes for 24 months

PARTICIPANTS:

Low-income Latino(a)s with type 2 diabetes DESIGN AND INTERVENTION We collected post-intervention clinical data for five cohorts (n = 101, mean n = 20/cohort) who participated in TIME programs from 2018 to 2020 in Houston, Texas. MAIN

MEASURES:

We gathered HbA1c (primary outcome), weight, body mass index (BMI), and blood pressure data at baseline, 6 months (intervention end), and semiannually thereafter until 24 months after baseline to assess sustainability. We also evaluated participant loss to follow-up until 24 months. KEY

RESULTS:

Participants decreased HbA1c levels during the intervention (p < 0.0001) and maintained these improvements at each timepoint from baseline to 24 months (p range < 0.0001 to 0.015). Participants reduced blood pressure levels during TIME and maintained these changes at each timepoint from baseline until 18 months (systolic p range < 0.0001 to 0.0005, diastolic p range < 0.0001 to 0.008) but not at 24 months (systolic p = 0.065; diastolic p = 0.85). There were no significant weight changes during TIME or post-intervention weight (p range = 0.07 to 0.77), BMI (p range = 0.11 to 0.71). Attrition rates (loss to follow-up during the post-intervention period) were 5.9% (6 months), 24.8% (12 months), 35.6% (18 months), and 41.8% (24 months).

CONCLUSIONS:

It is possible for vulnerable populations to maintain long-term glycemic and blood pressure improvements using a multiple dimensional intervention. Attrition rates rose over time but show promise given the majority of post-intervention timepoints occurred during the COVID-19 pandemic when low-income populations were most susceptible to suboptimal healthcare access. Future studies are needed to evaluate longitudinal outcomes of diabetes interventions conducted by local clinics rather than research teams.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Diabetes Mellitus, Type 2 / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal: J Gen Intern Med Journal subject: Internal Medicine Year: 2022 Document Type: Article Affiliation country: S11606-021-07363-7

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Diabetes Mellitus, Type 2 / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal: J Gen Intern Med Journal subject: Internal Medicine Year: 2022 Document Type: Article Affiliation country: S11606-021-07363-7