A Hybrid Model of In-Person and Telemedicine Diabetes Education and Care for Management of Patients with Uncontrolled Type 2 Diabetes Mellitus: Findings and Implications from a Multicenter Prospective Study.

Autor: Tourkmani AM; Family and Community Medicine Department, Chronic Illness Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia., Alharbi TJ; Family and Community Medicine Department, Chronic Illness Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia., Rsheed AMB; Family and Community Medicine Department, Chronic Illness Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia., Alotaibi AF; Family and Community Medicine Department, Chronic Illness Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia., Aleissa MS; Family and Community Medicine Department, Chronic Illness Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia., Alotaibi S; Family and Community Medicine Department, Chronic Illness Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia., Almutairi AS; Family and Community Medicine Department, Chronic Illness Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia., Thomson J; Family and Community Medicine Department, Chronic Illness Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia., Alshahrani AS; Family and Community Medicine Department, Chronic Illness Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia., Alroyli HS; Family and Community Medicine Department, Chronic Illness Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia., Almutairi HM; Family and Community Medicine Department, Chronic Illness Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia., Aladwani MA; Family and Community Medicine Department, Chronic Illness Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia., Alsheheri ER; Family and Community Medicine Department, Chronic Illness Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia., Sati HS; Family and Community Medicine Department, Chronic Illness Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia., Aljuaid B; Family and Community Medicine Department, Chronic Illness Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia., Algarzai AS; Health Services, Ministry of Defense, Riyadh, Saudi Arabia., Alabood A; Family and Community Medicine Department, Chronic Illness Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia., Bushnag RA; Family and Community Medicine Department, Chronic Illness Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia., Ghabban W; Family and Community Medicine Department, Chronic Illness Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia., Albaik M; Family and Community Medicine Department, Chronic Illness Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia., Aldahan S; Family and Community Medicine Department, Chronic Illness Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia., Redda D; Family and Community Medicine Department, Chronic Illness Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia., Almalki A; Family and Community Medicine Department, Chronic Illness Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia., Almousa N; Family and Community Medicine Department, Chronic Illness Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia., Aljehani M; Health Services, Ministry of Defense, Riyadh, Saudi Arabia., Alrasheedy AA; Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim, Saudi Arabia.
Jazyk: angličtina
Zdroj: Telemedicine reports [Telemed Rep] 2024 Feb 19; Vol. 5 (1), pp. 46-57. Date of Electronic Publication: 2024 Feb 19 (Print Publication: 2024).
DOI: 10.1089/tmr.2024.0003
Abstrakt: Background: Patients with uncontrolled type 2 diabetes mellitus (T2DM) require close follow-up, support, and education to achieve glycemic control, especially during the initiation or intensification of insulin therapy and self-care management. This study aimed to describe and evaluate the impact of implementing a hybrid model of in-person and telemedicine care and education on glycemic control for patients with uncontrolled T2DM (hemoglobin A1c [HbA1c] ≥9%) during the coronavirus disease pandemic.
Methods: This prospective multicenter-cohort pre-/post-intervention study was conducted on patients with uncontrolled T2DM. This study included three chronic illness centers affiliated with the Family and Community Medicine Department at Prince Sultan Military Medical City in Riyadh, Saudi Arabia. A hybrid model of in-person (onsite) and telemedicine care and education was developed. This involved implementing initial in-person care at the physicians' clinic and initial in-person education at the diabetes education clinic, followed by telemedicine services of tele-follow-ups, support, and education for an average 4-month follow-up period.
Results: Of the enrolled 181 patients, more than half of the participants were women ( n  = 103, 56.9%). The mean age of participants (standard deviation) was 58.64 ± 11.23 years and the mean duration of diabetes mellitus was 13.80 ± 8.55 years. The majority of the patients ( n  = 144; 79.6%) were on insulin therapy. Overall, in all three centers, the hybrid model had significantly reduced HbA1c from 10.47 ± 1.23% to 7.87 ± 1.59% (mean difference of reduction 2.59% [95% confidence interval (CI) = 2.34-2.85%], p  < 0.001). At the level of each center, HbA1c was reduced significantly with mean differences of 3.17% (95% CI = 2.81-3.53%), 2.49% (95% CI = 1.92-3.06%), and 2.16% (95% CI = 1.76-2.57%) at centers A, B, and C, respectively (all p  < 0.001).
Conclusion: The findings showed that the hybrid model of in-person and telemedicine care and education effectively managed uncontrolled T2DM. Consequently, the role of telemedicine in diabetes management could be further expanded as part of routine diabetes care in primary settings to achieve better glycemic control and minimize nonessential in-person visits when appropriate.
Competing Interests: No competing financial interests exist.
(© Ayla M. Tourkmani et al., 2024; Published by Mary Ann Liebert, Inc.)
Databáze: MEDLINE