Browsing by Author "Wilkes, Meredith"

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    Baseline Quality Improvement Capacity of 33 Endocrinology Centers Participating in the T1D Exchange Quality Improvement Collaborative
    (American Diabetes Association, 2022) Marks, Brynn E.; Mungmode, Ann; Neyman, Anna; Levin, Laura; Rioles, Nicole; Eng, Donna; Lee, Joyce M.; Basina, Marina; Hawah-Jones, Nana; Mann, Elizabeth; O’Malley, Grenye; Wilkes, Meredith; Steenkamp, Devin; Aleppo, Grazia; Accacha, Siham; Ebekozien, Osagie; Pediatrics, School of Medicine
    This article describes the evolution of the Type 1 Diabetes Exchange Quality Improvement Collaborative (T1DX-QI) and provides insight into the development and growth of a successful type 1 diabetes quality improvement (QI) program. Since its inception 8 years ago, the collaborative has expanded to include centers across the United States with varying levels of QI experience, while simultaneously achieving many tangible improvements in type 1 diabetes care. These successes underscore the importance of learning health systems, data-sharing, benchmarking, and peer collaboration as drivers for continuous QI. Future efforts will include recruiting additional small- to medium-sized centers focused on adult care and underserved communities to further the goal of improving care and outcomes for all people living with type 1 diabetes.
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    Differences in COVID-19 Outcomes Among Patients With Type 1 Diabetes: First vs Later Surges
    (MDedge, 2022-01) Gallagher, Mary Pat; Rompicherla, Saketh; Ebekozien, Osagie; Wilkes, Meredith; Antal, Zoltan; Feuer, Alexis Jamie; Rioles, Nicole; Noor, Nudrat; Gabriel, Liana; O’Malley, Grenye; Golden, Lauren; Alonso, G. Todd; Ospelt, Emma; Odugbesan, Ori; Lyons, Sarah K.; Mungmode, Ann; Prahalad, Priya; Clements, Mark; Neyman, Anna; Demeterco-Berggren, Carla; Rapaport, Robert; Pediatrics, School of Medicine
    Background Outcomes of the novel coronavirus SARS-CoV-2 (COVID-19) have improved throughout the pandemic. However, whether outcomes of COVID-19 in the type 1 diabetes (T1D) population improved over time is unknown. Therefore, we aim to investigate differences in COVID-19 outcomes for patients with T1D in the US. Method We analyzed data collected via a registry of patients with T1D and COVID-19 from 56 sites between April 2020 and January 2021. First, we grouped cases into First Surge (04/09/2020 - 07/31/2020, n=188) and Late Surge (08/01/2020 - 01/31/2021, n=410). Then, we compared outcomes between both groups using descriptive statistics and logistic regression models. Results Adverse outcomes were more frequent during the first surge including Diabetic Ketoacidosis (32% versus 15%, p<0.001), severe hypoglycemia (4% versus 1%, p=0.04) and hospitalization (52% versus 22%, p<0.001). The First surge cases were older (28 +/- 18.8 years versus 18.8 +/- 11.1 years, p<0.001), had higher hemoglobin A1c (HbA1c) levels (Median (IQR): 9.3 (4.0) versus 8.4(2.8), <0.001) and use public insurance (n(%): 107 (57) versus 154 (38), p <0.001). There were five times increased odds of hospitalization for adults (OR 5.01 (2.11,12.63) in the first surge compared to the late surge. Conclusion COVID-19 cases among patients with T1D reported during the first surge had a higher proportion of adverse outcomes than those presented in a later surge.
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    Institutional Barriers to the Successful Implementation of Telemedicine for Type 1 Diabetes Care
    (American Diabetes Association, 2024) Lee, Joyce M.; Ospelt, Emma; Noor, Nudrat; Mungmode, Ann; Ebekozien, Osagie; Gupta, Meenal; Malik, Faisal S.; Fogel, Naomi R.; Accacha, Siham; Hsieh, Susan; Wilkes, Meredith; Neyman, Anna; Vendrame, Francesco; T1D Exchange Quality Improvement Collaborative; Pediatrics, School of Medicine
    The aim of this study was to describe rates of telemedicine use 18 months after the start of the coronavirus disease 2019 pandemic and to assess the institutional barriers to its implementation for type 1 diabetes care across centers of the T1D Exchange Quality Improvement Collaborative. Observational electronic health record data capturing telemedicine rates from 15 U.S. centers between September 2020 and September 2021 and a survey of 33 centers capturing telemedicine rates and key components of telemedicine were analyzed. A capacity score was developed and summed to a total capacity score and compared with overall telemedicine rates across centers. Telemedicine visits decreased by 17.4% from September 2020 to September 2021. Generally, it was observed that the lower the average telemedicine capacity score, the lower the rate of telemedicine visits. Despite a decline in the utilization of telemedicine 18 months after the start of the pandemic, visit rates were still 20% higher than in the pre-pandemic period. However, there is a need to improve structural components to ensure telemedicine capacity and robust telemedicine utilization.