N/A N=33,100

Comparative Effectiveness of Telemedicine in Primary Care

Asthma · Chronic Obstructive Pulmonary Disease (COPD) · Congestive Heart Failure · Diabetes · Hypertension

Bottom Line

View on ClinicalTrials.gov: NCT04684836 ↗

Enrolled (actual)

33,100

Serious AEs

—

Results posted

Sep 2024

Primary outcome: Primary: Preventable Emergency Department (ED) Admissions — 0.038; 0.048 count of ED admissions per person per q — p=0.0793

Study Design & Population

Study type: Observational
Phase: N/A
Interventions: Exposure to telemedicine, after the onset of the pandemic (Other)
Age: Adult, Older Adult · 19+ yrs
Sex: All
Sponsor: Weill Medical College of Cornell University
Primary completion: Apr 2022

Outcome Measures

Outcome	Result	p-value
PRIMARY Preventable Emergency Department (ED) Admissions	0.038; 0.048	0.0793
PRIMARY Unplanned Hospital Admissions From the ED	0.015; 0.020	0.3261
PRIMARY Continuity of Care as Assessed by the Breslau Usual Provider of Care Measure	—	—
PRIMARY Number of Unplanned Hospital Admissions From the ED	—	—
PRIMARY Continuity of Care as Assessed by the Bice-Boxerman Continuity of Care Index	—	—
PRIMARY Number of Unplanned Hospital Admissions From the ED	—	—
PRIMARY Number of Unplanned Hospital Admissions From the ED	—	—
PRIMARY Number of Avoidable Emergency Department (ED) Admissions	—	—
PRIMARY Number of Avoidable Emergency Department (ED) Admissions	—	—
PRIMARY Number of Avoidable Emergency Department (ED) Admissions	—	—
PRIMARY Continuity of Care as Assessed by the Bice-Boxerman Continuity of Care Index	—	—
PRIMARY Continuity of Care as Assessed by the Bice-Boxerman Continuity of Care Index	—	—
PRIMARY Continuity of Care as Assessed by the Bice-Boxerman Continuity of Care Index	—	—
PRIMARY Continuity of Care as Assessed by the Breslau Usual Provider of Care Measure	—	—
PRIMARY Continuity of Care as Assessed by the Breslau Usual Provider of Care Measure	—	—
PRIMARY Continuity of Care as Assessed by the Breslau Usual Provider of Care Measure	—	—
PRIMARY Continuity of Care as Assessed by Attendance at Follow-up Appointment	—	—
PRIMARY Continuity of Care as Assessed by Attendance at Follow-up Appointment	—	—
PRIMARY Continuity of Care as Assessed by Attendance at Follow-up Appointment	—	—
PRIMARY Continuity of Care as Assessed by Attendance at Follow-up Appointment	—	—
SECONDARY Evidence of Controlled Disease as Indicated by as Indicated by the National Quality Forum (NQF 0059): Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)	—	—
SECONDARY Evidence of Controlled Disease as Indicated by as Indicated by the National Quality Forum (NQF 0059): Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)	—	—
SECONDARY Evidence of Controlled Disease as Indicated by as Indicated by the National Quality Forum (NQF 0059): Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)	—	—
SECONDARY Evidence of Controlled Disease as Indicated by as Indicated by the National Quality Forum (NQF 0059): Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)	—	—
SECONDARY Evidence of Controlled Disease as Indicated by as Indicated by the National Quality Forum (NQF 0018): Controlling High Blood Pressure	—	—
SECONDARY Evidence of Controlled Disease as Indicated by as Indicated by the National Quality Forum (NQF 0018): Controlling High Blood Pressure	—	—
SECONDARY Evidence of Controlled Disease as Indicated by as Indicated by the National Quality Forum (NQF 0018): Controlling High Blood Pressure	—	—
SECONDARY Evidence of Controlled Disease as Indicated by as Indicated by the National Quality Forum (NQF 0018): Controlling High Blood Pressure	—	—
SECONDARY Days at Home	—	—
SECONDARY Days at Home	—	—
SECONDARY Days at Home	—	—
SECONDARY Days at Home	—	—
SECONDARY Patient Experiences Based on the Patient Satisfaction Questionnaire (PSQ-18)	—	—
SECONDARY Ease of Use and Access to Telemedicine Based on Telehealth Usability Questionnaire (TUQ)	—	—

Summary

Leveraging a natural experiment approach, the investigators will examine rapidly changing telemedicine and in-person models of care during and after the COVID-19 crisis to determine whether certain patients could safely choose to continue telemedicine or telemedicine-supplemented care, rather than return to in-person care.

Eligibility Criteria

Inclusion Criteria

patients that are attributed to primary care clinics across four health systems in the INSIGHT (Mount Sinai Health System and Weill Cornell Medicine), OneFlorida (University of Florida Health), and STAR (University of North Carolina Health) CRNs.
Patients received two or more outpatient visits at a participating practice during a one-year period before the COVID-19 pandemic,
Patients had one or more of five chronic illnesses (asthma, chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), diabetes, hypertension) as defined by the Medicare Chronic Conditions Warehouse algorithm

Exclusion Criteria

Patients who tested COVID-positive
Patients from hospice and palliative care practices
Patients from osteopathic medicine practices
Patients from pediatric practices
Patients that did not reside in states where the four health systems were located: the New York-Tri State Area (Connecticut, New York, and New Jersey), Florida, and North Carolina.
Patients that moved out of state (or out of the New York-Tri State Area) or who died during the study period were also excluded.
Patients who were not continuously enrolled over the entire study period (2019-2021).

View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT04684836). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.