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: Ayla M. Tourkmani, Turki J. Alharbi, Abdulaziz M. Bin Rsheed, Azzam F. Alotaibi, Mohammed S. Aleissa, Sultan Alotaibi, Amal S. Almutairi, Jancy Thomson, Ahlam S. Alshahrani, Hadil S. Alroyli, Hend M. Almutairi, Mashael A. Aladwani, Eman R. Alsheheri, Hyfaa Salaheldin Sati, Budur Aljuaid, Abdulaziz S. Algarzai, Abood Alabood, Reuof A. Bushnag, Wala Ghabban, Muhammed Albaik, Salah Aldahan, Dalia Redda, Ahmed Almalki, Noura Almousa, Mohammed Aljehani, Alian A. Alrasheedy
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Telemedicine Reports, Vol 5, Iss 1, Pp 46-57 (2024)
Druh dokumentu: article
ISSN: 2692-4366
DOI: 10.1089/TMR.2024.0003
Popis: 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?
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