Effect of video conferencing between primary and secondary care specialists on type 2 diabetes medication

Abstract

Although promising, the clinical impact of video conferencing between primary and secondary care specialists lacks trial evidence. We conducted a two-arm RCT (clinicaltrials.gov: NCT05268081) to evaluate whether four video conferences over 12 months between endocrinologists and general practitioners improved medication for people with type 2 diabetes (T2D). Twenty-seven of 100 general practices in Aarhus, Denmark were matched and randomized. Primary outcomes: the proportion of people with T2D and 1) ischemic heart disease treated with glucagon-like peptide 1 receptor agonist (GLP1-RA) and/or sodium glucose cotransporter 2 inhibitor (SGLT2I), 2) micro/macro-albuminuria treated with angiotensin-converting-enzyme-inhibitor (ACE) or angiotensin-2-receptorantagonist (AT2), 3) low-density lipoprotein >2.5 mmol/L treated with statins. Results showed a 17.6% difference [95% CI 4.6%; 30.7%] in GLP1-RA/SGLT2I prescriptions and minimal differences for ACE/AT2 (−1.1% [95% CI −2.8%; 0.6%]) and statins (0.0% [95% CI −3.5%; 3.6%]), attributed to a ceiling effect. Video conferencing can help bridge treatment gaps, particularly for recently updated guidelines.