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869-P: Patient-Provider Video Visit Use and HbA1c Control among Patients with Diabetes

Video telemedicine can offer patients direct real-time convenient access to clinicians without arranging transportation or work time-off, improving access to diabetes care and self-management support. We examined the association between video visit use and hemoglobin A1c (HbA1c) among patients with diabetes. In a longitudinal study, within a large integrated delivery system where patients were first able to self-schedule real-time physician video visits in 2016, we used the clinical registry to identify patients with diabetes (2015), and followed their video visit use and subsequent HbA1c values over time (2016-2019). Using linear regression with patient-level fixed effects (within-patient changes), adjusting for calendar year and month and time-changing patient mobile portal access, we measured the association between use of video visits as a time-changing variable and the patient’s yearly HbA1c values (in subsequent calendar years after video visit use). We then stratified analyses by baseline HbA1c value: Among 204,301 patients with diabetes, 50% were 65 years or older, 48% were women, and 45% were of white race/ethnicity. Overall, 95% of patients had a baseline HbA1c value, 24% had HbA1c values ≥8%. Patient use of video visits was associated with an overall statistically significant reduction in HbA1c value by 0.15% (95% CI: 0.11%-0.19%). Among those with baseline HbA1c values ≥8%, using video visits was associated with a HbA1c value reduction of 0.22% (95% CI: 0.12%-0.32%), and among patients with lower baseline engagement (i.e., no baseline HbA1c measurement), using video visits was associated with a HbA1c reduction of 0.39% (95% CI: 0.07%-0.71%). Use of video visit was associated with improved glycemic control among patients with diabetes, with greater improvements found among patients with worse baseline control and lower engagement. Video visits may offer convenient health care access to improve diabetes management. Disclosure M. Reed: None. A. Gopalan: None. I. Graetz: None. L. Hsueh: None. J. Huang: None. E. Muelly: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (R01DK085070)