Communication about diabetes risk factors during between-visit encounters

Area of Science:

• Health Services Research
• Diabetes Care
• Patient-Provider Communication

Background:

• Secure messaging and phone encounters are increasingly used to enhance patient access between ambulatory care visits.
• These communication methods hold potential for improving diabetes risk factor control.
• However, the content of these encounters relative to traditional in-person visits is not well understood.

Purpose of the Study:

• To compare patient-reported communication about diabetes risk factors (glucose, blood pressure, cholesterol) during in-person, phone, and secure messaging encounters.
• To identify patient characteristics associated with reporting risk factor discussions during between-visit encounters.

Main Methods:

• Cross-sectional analysis of survey and electronic health record data from 569 patients with diabetes.
• Examined patient-reported communication during in-person, phone, and secure messaging encounters.
• Analyzed associations between communication and patient demographics, health status, and encounter type.

Main Results:

• 77% of patients used between-visit encounters (63% phone, 41% secure messaging).
• Discussions about glucose, blood pressure, and cholesterol were significantly less frequent during between-visit encounters compared to in-person visits.
• Younger, more educated, Black or other race/ethnicity patients, those on insulin, or with poor glycemic control were more likely to discuss risk factors during between-visit encounters.

Conclusions:

• Patients with diabetes reported fewer risk factor discussions during between-visit encounters (phone, secure messaging) than in-person visits.
• These findings indicate potential missed opportunities for proactive management and support of diabetes risk factors.
• Further research is needed to optimize the use of technology for diabetes care between visits.