Effects of Telehealth Monitoring on Glycemic Control and Medication Adherence in Patients with Poorly Controlled Type 2 Diabetes
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Abstract
Background: Diabetes patients with poor glycemic control have increased risk to develop diabetes-related complications. Patients with diabetes need diabetes self-management education to achieve glycemic target treatment and continue long term care. The use of technology in health education (telehealth) is a convenient and uncomplicated option to monitor the blood sugar level, symptoms of hypoglycemic or hyperglycemic status and the emergence of diabetes. Diabetes patients can easily and quickly access to treatment in a timely manner.
Objective: To evaluate the effects of telehealth monitoring on glycemic control and medication adherence in patients with poorly controlled type 2 diabetes who receive service in Comprehensive NCDs clinic Vajira Hospital.
Method: An experimental study was conducted. A total of 60 subjects were divided into 30 experimental and 30 control groups. All patients receive diabetes self-management education: DSME and followed up for 1 year. The experimental group was followed up by phone using an application line to communicate, educate, evaluate, monitor self-monitoring blood glucose (SMBG) and resolve hypoglycemia or hyperglycemia symptom. The control group was served during the scheduled doctor’s visits. The effect of glycemic control and medication adherence were assessed periodically 3 months and after 12 months of follow-up.
Results: Fasting blood glucose and HbA1C after the 1 year experiment were significantly reduced both in the experimental and control group. There were greater statistically significant reduction in the experimental group than the control group (p-value < 0.001). Comparison of medication adherence before the trial, 96.4% of both groups had low adherence score. At the end of trial, both groups had a statistically significant increase in medication adherence. While the experimental group who received telehealth monitoring was a greater increase in medication adherence than the control group.
Conclusion: Applying telehealth as a tool for continuing diabetes care can facilitate patients to modify health behaviors. This telehealth enhance the ability of self-management and improve clinical outcomes.
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