ArticleJournal of general internal medicine2022
Implementation of an Intensive Telehealth Intervention for Rural Patients with Clinic-Refractory Diabetes.
Article in Journal of general internal medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 3 syntheses or guidelines pooled it, 23 citations in OpenAlex.
- Barriers and Facilitators to Implementing Digital Health Technologies for Remote Management of NCDs in Rural Areas: Mixed Methods Systematic Review.Journal of medical Internet research · 2026Pooled it
- A systematic review of the scope and impact of rural primary healthcare innovations using digital health technology.BMJ open · 2026Pooled it
- Factors Influencing the Uptake of Digital Health Interventions for Cardiovascular Disease Prevention Among Healthcare Providers: A Systematic Review.Global heart · 2026Pooled it
- Expanding Technology-Enabled, Nurse-Delivered Chronic Disease Care : A Pragmatic, Randomized, Effectiveness-Implementation Trial.Annals of internal medicine · 2026Trial
- Village doctor-led integrated care for older adults with diabetes in rural China: a cluster-randomized pilot trial.BMC geriatrics · 2026Trial
- Implementing Advanced Comprehensive Diabetes Care Within the Veterans Affairs Learning Health System.Journal of general internal medicine · 2026Article
- SGLT2i and GLP-1RA Use in the USA.Journal of general internal medicine · 2026Article
- Nursing practices in Primary Health Care in rural areas: a scoping review.Revista brasileira de enfermagem · 2026Article
- 1. Improving Care and Promoting Health in Populations: Standards of Care in Diabetes-2026.Diabetes care · 2026Review
- The forgotten - overcoming challenges in diabetes care for marginalized populations.Expert review of endocrinology & metabolism · 2025Review
- Sustained metabolic improvements in a remotely delivered ketogenic nutrition programme for veterans with type 2 diabetes: A 3-year observational study.Diabetes, obesity & metabolism · 2025Observational
- Decarbonizing Health Care: Measuring the Carbon Footprint Impact of a National VA Telehealth Program.NEJM catalyst innovations in care delivery · 2025Article
- A successful remote patient monitoring program for diabetes.Frontiers in endocrinology · 2025Article
- 1. Improving Care and Promoting Health in Populations: Standards of Care in Diabetes-2025.Diabetes care · 2025Review
- Article
- Identifying Patterns of Primary Care In-Person and Telemedicine Use in the Veterans Health Administration: A Latent Class Analysis.Journal of general internal medicine · 2024Article
- Evaluating the Impact of Telemedicine on Diabetes Management in Rural Communities: A Systematic Review.Cureus · 2024Review
- Implementing evidence-based practices in rural settings: a scoping review of theories, models, and frameworks.Frontiers in health services · 2024Article
- Factors Influencing Compliance to Follow-up Visits in Orthopaedic Surgery.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2024Article
- 1. Improving Care and Promoting Health in Populations: Standards of Care in Diabetes-2024.Diabetes care · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
25 authors at 9 institutions in 1 country.
Funding
Abstract
backgroundRural patients with type 2 diabetes (T2D) may experience poor glycemic control due to limited access to T2D specialty care and self-management support. Telehealth can facilitate delivery of comprehensive T2D care to rural patients, but implementation in clinical practice is challenging.
objectiveTo examine the implementation of Advanced Comprehensive Diabetes Care (ACDC), an evidence-based, comprehensive telehealth intervention for clinic-refractory, uncontrolled T2D. ACDC leverages existing Veterans Health Administration (VHA) Home Telehealth (HT) infrastructure, making delivery practical in rural areas.
designMixed-methods implementation study.
participants230 patients with clinic-refractory, uncontrolled T2D.
interventionACDC bundles telemonitoring, self-management support, and specialist-guided medication management, and is delivered over 6 months using existing VHA HT clinical staffing/equipment. Patients may continue in a maintenance protocol after the initial 6-month intervention period. MAIN MEASURES: Implementation was evaluated using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. The primary effectiveness outcome was hemoglobin A1c (HbA1c). KEY
resultsFrom 2017 to 2020, ACDC was delivered to 230 patients across seven geographically diverse VHA sites; on average, patients were 59 years of age, 95% male, 80% white, and 14% Hispanic/Latinx. Patients completed an average of 10.1 of 12 scheduled encounters during the 6-month intervention period. Model-estimated mean baseline HbA1c was 9.56% and improved to 8.14% at 6 months (- 1.43%, 95% CI: - 1.64, - 1.21; P < .001). Benefits persisted at 12 (- 1.26%, 95% CI: - 1.48, - 1.05; P < .001) and 18 months (- 1.08%, 95% CI - 1.35, - 0.81; P < .001). Patients reported increased engagement in self-management and awareness of glycemic control, while clinicians and HT nurses reported a moderate workload increase. As of this submission, some sites have maintained delivery of ACDC for up to 4 years.
conclusionsWhen strategically designed to leverage existing infrastructure, comprehensive telehealth interventions can be implemented successfully, even in rural areas. ACDC produced sustained improvements in glycemic control in a previously refractory population.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.