Introduction and Objective: The increase in endocrinology telemedicine visit use since 2020 has had unclear impacts on care quality. This study sought to determine the association between different rates and types of telemedicine visit use and monitoring of cardiorenal risk factors in patients with diabetes.Methods: In this retrospective study, we examined the relationship between video and phone telemedicine visit use and completion of low-density lipoprotein (LDL) cholesterol, urine microalbumin, and blood pressure testing in patients seen by endocrinology for diabetes at a large integrated health system. We studied adults with at least two diabetes visits during the evaluation year (2022).Results: The study population (n=13,246) was 51.3% female with a mean age of 63.3 years. Completion rates for LDL cholesterol, microalbumin, and blood pressure screenings were 76.6%, 67.8%, and 98.1% respectively. Patients had a mean of 23.7% telemedicine visits in 2022 (19.2% video, 4.5% phone). Patients who had only telemedicine visits in 2022 were less likely to have completed screening for all three risk factors than patients with some or no telemedicine visits (49.3% vs. 62.3% vs. 59.6%; p < 0.001). Multivariable logistic regression analysis adjusted for demographic and clinical covariates and screening completion in the previous year (2021) demonstrated that patients with a higher fraction of video and phone visits were less likely to have LDL cholesterol (OR 0.84, p<0.0001; OR 0.71, p<0.0001), microalbumin (OR 0.77, p<0.0001; OR 0.42, p<0.0001), and blood pressure (OR 0.14, p<0.0001; OR 0.09, p<0.0001) testing completed (all ORs correspond to a 50% increase in the fraction of video/phone visits).Conclusion: Higher rates of phone and video visits were associated with a decreased probability of cardiorenal risk factor monitoring. This suggests additional care delivery measures are needed to ensure test completion for patients with a high proportion of telemedicine visits.
E.G. Thurber: Other Relationship; SimulConsult. Z. Lan: None. A. Turchin: Consultant; Novo Nordisk. Research Support; Eli Lilly and Company. Consultant; Proteomics International.
National Institutes of Health (T32DK007529)
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