Patient perceptions of rural telehealth diabetes control program in Department of Veteran's Affairs

The prevalence of diabetes mellitus in the Department of Veteran's Affairs (VA) is higher than in the general public, with nearly 25% of Veterans enrolled in VA care diagnosed with diabetes. VA cares for over 2.7 million Veterans in rural areas who may face barriers to accessing specialty care for diabetes management. The goal of this study was to understand Veteran patient experiences with a novel telehealth diabetes program designed to improve diabetes care for Veterans in rural areas.

We conducted a qualitative evaluation of Veteran's experiences as part of a larger mixed methods evaluation of the VA Telediabetes program. We conducted semistructured interviews with rural Veterans enrolled in the program to understand their experiences and perceptions. We conducted an inductive-deductive content analysis to identify salient themes related to diabetes control, perceptions of telehealth for diabetes care, and previous experiences with diabetes management. Methods are described according to the SRQR checklist for qualitative research.

We conducted interviews with 26 rural Veterans enrolled in the Telediabetes program between April 2022 and March 2023 and identified three themes related to their experience in the program: (1) Telediabetes care is more frequent and comprehensive than previous diabetes care; (2) Telediabetes care is convenient and thorough, but there are some barriers; and (3) Patients describe that their diabetes control as better in Telediabetes program compared to diabetes management in primary care.

Veterans perceived that Telediabetes had a positive impact on their diabetes control and described the quality of care as excellent. Programs like Telediabetes bring together a group of interdisciplinary specialists to provide care for rural patients have the potential to alleviate barriers to specialty care in rural areas.