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March 17, 2021Telemedicine Journal and e-HealthOpen Access

HOPE telehealth shows no significant benefit over enhanced usual care for reducing diabetes distress.

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Why the study?

Diabetes distress is underrecognized and associated with poor outcomes, motivating evaluation of a telehealth intervention to reduce distress levels.

Does a collaborative, goal-setting, and behavioral telehealth intervention reduce diabetes distress in individuals with uncontrolled diabetes and depression?

Population

225 individuals with uncontrolled diabetes and depression living at least 20 miles from a Veteran's Affairs medical center

Comparison

12-month collaborative, goal-setting, and behavioral telehealth intervention (HOPE) vs Enhanced Usual Care (EUC) with education

Design

Randomized clinical trial

Follow-up

12 months

Key result

The HOPE telehealth intervention trended toward improving overall diabetes distress compared with enhanced usual care, but the difference was not statistically significant (β=6.96; P=0.13).

Authors

EVElizabeth M. VaughanJCJeffrey A. CullyNPNancy J. Petersen

Discussion

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Member takes

Overview

Does not support telehealth adoption for diabetes distress; leaves open benefit in larger or refined trials.

Study Design

Type

RCT (n=225)

Randomization

randomized

Structured PICO

Does a collaborative, goal-setting, and behavioral telehealth intervention reduce diabetes distress in individuals with uncontrolled diabetes and depression?

P
Population
225 individuals with uncontrolled diabetes and depression living at least 20 miles from a Veteran's Affairs medical center, followed for 12 months.
I
Intervention
12-month collaborative, goal-setting, and behavioral telehealth intervention (HOPE)
C
Comparator
Enhanced Usual Care (EUC) with education
O
Outcome
Diabetes distress levels as measured by the Problem Areas in Diabetes (PAID) Questionnaire and its four subscales (emotional, diabetes management, social, and treatment distress) at 6 and 12 monthspatient reported

Main Result

Effect estimate: β 6.96

p-value: p=0.13

A 12-month telehealth intervention for patients with uncontrolled diabetes and depression yielded clinically meaningful but not statistically significant overall reductions in diabetes distress over time compared to enhanced usual care.

Cite This Study

Vaughan et al. (2021) conducted an RCT in uncontrolled diabetes and depression (n=225). Healthy Outcomes through Patient Empowerment (HOPE) telehealth intervention vs. Enhanced Usual Care (EUC) with education was evaluated on Overall diabetes distress (PAID total score) over 12 months (β 6.96, p=0.13). The HOPE telehealth intervention trended toward improving overall diabetes distress compared with enhanced usual care, but the difference was not statistically significant (β=6.96; P=0.13).

synapsesocial.com/papers/6aaba10ce6ff321f5351eedfhttps://doi.org/10.1089/tmj.2020.0533
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1A Tele-Behavioral Health Intervention to Reduce Depression, Anxiety, and Stress and Improve Diabetes Self-Management2016 · 42 citations
  2. 2A Randomized Trial of Telephonic Counseling Plus Walking for Depressed Diabetes Patients2011 · 204 citations
  3. 3680-P: PAID-ing Off through Personalized Chronic Disease Management—Promising Preliminary Analysis in Alleviating Diabetes-Related Distress2024
  4. 41591-P: Telehealth vs. In-Person Versions of a Diabetes Distress–Reducing Intervention for Teens2026
  5. 5Evaluation of the clinical outcomes of telehealth for managing diabetes2018 · 94 citations