Feinstein doc eyes telehealth for Hispanic diabetes

House call: Telehealth solutions may prove to be a critical innovation for Hispanic patients suffering from type 2 diabetes.
By GREGORY ZELLER //

It’s not precisely the Telemundo of telemedicine, but a Long Island scientist will spend some $3 million of the Patient-Centered Outcomes Research Institute’s money exploring telehealth protocols for Hispanic diabetes patients.

The PCORI, a government-funded (but non-government) Washington-based organization that supports and investigates various medical treatments, is backing Feinstein Institute for Medical Research professor Renee Pekmezaris’ study of home telemonitoring for Hispanic-community patients living with type 2 diabetes, the most common form of the metabolic disorder.

The new grant, weighing in at a hefty $3.03 million, is the professor’s third PCORI award – she earned prior PCORI grants for telehealth studies focused on underserved heart failure and chronic obstructive pulmonary disease patients – and is earmarked exclusively for the development of telemedicine programs for Hispanic diabetes patients.

With an eye on language barriers and other cultural differences, the study will consist of two phases. First, Pekmezaris’ research team will be seasoned by a Diabetes Community Advisory Board including patients, clinicians and representatives of the American Diabetes Association.

In the second phase, the team will conduct a “randomized clinical trial” to determine whether Hispanic patients who receive “adapted telemonitoring intervention” fare better than Hispanic patients receiving standard outpatient care, according to the Feinstein Institute.

During that clinical-trial portion of the study, healthcare providers will conduct regular online video visits with patients via tablets in the patients’ homes. Patients and caregivers (including non-English-speaking patients and caregivers) will be able to share updates that help providers adjust treatment plans in real time, while offering valuable feedback on the telehealth effort itself.

While previous studies have reinforced the benefits of diabetes-focused telemedicine programs in low-income communities, no current program is tailored specifically to Hispanic communities – placing additional emphasis on Pekmezaris’ work, particularly among the 33 percent of U.S. Hispanics who will develop type 2 diabetes in their lifetime.

Renee Pekmezaris: Telemedicine to the rescue.

Half of those patients suffer an “illness burden” and a mortality rate that’s 50 to 100 percent higher than non-Hispanic white diabetes patients, putting a real premium on innovative treatment options, according to Pekmezaris, who is also a professor in the Department of Population Health at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell and vice president of community health and health services research for Northwell Health.

“A diagnosis of type 2 diabetes can mean a major change in a patient’s lifestyle, with regular blood testing, changes in diet and exercise and even insulin shots,” the professor noted. “The addition of language barriers and cultural differences can make managing this disease overwhelming for patients.”

Pekmezaris’ study earned the PCORI grant through a competitive review process in which patients, clinicians and other stakeholders evaluated proposals based on scientific merit, patient engagement, methodological rigor and other criteria.

The grant will be finalized pending completion of a business and programmatic review by PCORI staff and issuance of a formal award contract – formalities, according to PCORI Executive Director Joe Selby, who noted Pekmezaris’ proposal was selected “not only for its scientific merit and commitment to engaging patients and other stakeholders, but also for its potential to fill an important gap in our health knowledge.”

“We look forward to following the study’s progress and working with the Feinstein Institute for Medical Research to share the results,” Selby said in a statement.

Whenever the final award is issued and the study properly commences, it won’t be too soon, according to Pekmezaris, who thanked the PCORI for supporting her quest to assist a diabetes-patient population that truly needs the help.

“I’m confident that we will be able to offer Hispanic patients a telehealth program that makes the diabetes diagnosis less cumbersome,” Pekmezaris said. “By offering regular check-ins from a medical professional and identifying early warning signs of larger medical issues before the patient becomes sick, we hope to improve quality as well as length of life.”


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