Older patients’ preferences and views related to non-face-to-face diabetes chronic care management: a qualitative study from southeast Louisiana

Figures & data

Table 1 Patient characteristics

Patients Interviewed for PCORI LEAD Study (n=30), 2017–2018
	Frequency or mean	Percent of total
Health system
Ochsner	26	(87%)
Tulane	5	(17%)
UMC	0	(0%)
Other	2	(7%)
Participated in Medicare-reimbursed NFF CCM	4	(13%)
Participated in other NFF care	26	(87%)
Age (mean)	68
Sex
Male	10	(33%)
Female	20	(67%)
Insurance
Medicare	21	(70%)
Dual-eligible	6	(20%)
Private	3	(10%)
Years since DM Dx (mean)	14
Other chronic conditions reported
BP	18	(60%)
Cholesterol	6	(20%)
Arthritis	7	(23%)
Cancer	4	(13%)
Deaf	1	(3%)
Injury	2	(7%)
CHF	7	(23%)
Sleep apnea	1	(3%)
Kidney	2	(7%)
Other	4	(13%)

Box S1 Case study

Case study: patient with severe chronic conditions (67 year old female) Comorbidities [I have] heart disease, high blood pressure, COPD, acid reflux, osteoarthritis, and I have sleep disorder, sleep apnea. As far as my heart go, I have difficulties with prolonged standing, shortness of breath. I suffer from atrial fibrillation, and I have a pacemaker. And as far as my leg, my right leg has a total knee replacement in it. And the COPD causes my shortness of breath. My diabetes is I’ve gotten it under control. I have chronic pancreatitis. I had heart surgery… and then I had a heart attack…, and I’m doing pretty well after that, but I still have to have another heart surgery… There’s a lot of things wrong with me, but I gotta say I get around pretty good. I had a stroke in May… I was 402 pounds, and now I’m only 287, and I’m still trying to get my weight down some more. Issues with diet and health But, thankfully, I just have to be mindful of my diabetes ‘cause I’ve never eaten proper ‘cause… I didn’t know exactly what to eat. And so I read everything, to try – I mean when I see literatures around in doctors’ office, I pick ‘em up and see if there’s new something, anything new I can do. So since I been doing that, like when I had my complete blood work done for my chest and everything, she said my A1C was good. It had improved so much. Care coordination I have one of the nurses from [health system]. She keeps up with me and monitor me and everything, and she calls me like about, oh, once or twice a week. And so if I don’t hear from her, within a week she make sure she get back with me. But we started out with calls once a week – no, twice a week – and then she says things were better; “I feel like I’m more comfortable with the issues, so I’m calling you like every two weeks.” That’s one of the registered nurses… I have her phone number in my phone. I have no problem with my doctors. I can call ‘em if I need ‘em. I get return calls. I have no problem getting appointments set. Even if I’m in distress about something, I can call ‘em and they’ll be wanting to see me the same day. I have some very, very good doctors. They’re all specialists and they keep a pretty close eye on me because they know I’m not a person like – I don’t like hospital stays. Starting the program They called me after [the heart attack]. I wasn’t even aware of this program. I never knew of it. But then when she called me and identified herself…and when I go to the hospital, I have this appointment, she’ll meet me at the doctors. You know, she never had to come in home, but when I go to my doctor’s appointment, she would call me: “You have a doctor’s appointment coming up.” She says, at such-and-such a date and at such-and-such a time, this is your appointment date to go see a cardiologist or neurology or whichever I’m going. She say, “And I’ll meet you there. Keep that appointment…I’ll meet you there.” ‘Cause I’m trying to keep all my appointments this time. And she’ll, when I get there, you know, she’ll come in and sit with me and go back with me to the doctors, in there with ‘em and talk with ‘em and see. She’s the one I get all my Ochsner, my charts, you know, get everything up to date there… Patient reported benefit from using NFF CCM (not primarily diabetes program) [CCM Nurse] told me I could join the senior community… They called me last Friday ‘cause they were trying to see about me getting food, so I have the right date… because I get $25.00 of food stamps. One time we was on the phone and it was like over an hour we were just talking. And she was.. answering all my questions, and she was just telling me different things that would benefit me. And she went and she said, “I’m gonna send you some literature out for you.” And then she kinda told me, asked me, if I needed to talk with someone, to tell her. I said, I talk to you. Believe it or not, I said, I feel better when I get off the phone with you. There’s so much stuff going on [family members with terminal illness] … I’d cry and I don’t know why… And she said, “You do that often?” and I say, “Yeah, a lot of times. I just cry. I don’t know.” She said, “You really are getting depressed. You need to –” and I would never go talk to anybody. I didn’t want that. I said, “No, thanks.” I said, “But I feel fine after I get off the phone with you.” And Dr. T said all of that can still mess with my diabetes… ..it’ll be a little more personal with her [the nurse], but then my doctors are always wanting to know what’s going on and the same things: the kinda questions you have, or have you been doing this, or I want you to still doing that, and make sure you do it. Cause…I tell ‘em, “I’m not gonna do that.” Then when he knows I told ‘em that, they know I’m not gonna do it… But Nurse L, it’s been a little different, really, really good. I love to talk with her… the program benefits me a lot. I like it. Yeah. I like it. It’s informative.