Noninferiority of Telemedicine Delivered Compared With In-person Diabetes Self-Management Education and Support (DSMES) During Covid-19 Pandemic in Thailand

Abstract

This study aimed to compare the clinical outcomes and program satisfaction of diabetes self-management education and support (DSMES) for type 2 diabetes patients delivered by telehealth during COVID-19 pandemic to in-person delivery during pre-COVID-19. A retrospective case-controlled study was conducted (95 telehealth and 95 on-site). Differences in hemoglobin A1c (HbA1c) reductions between groups were analyzed by linear mixed-effects models, and satisfaction was collected. Compared with baseline, at the three-month follow-up, the HbA1c reductions of the telehealth and on-site DSMES were 1.20 ± 0.15% and 1.21 ± 0.15%, respectively ( P < .001), whereas these were 1.28 ± 0.16% and 1.18 ± 0.15% at six-month follow-up, respectively ( P < .001). There were no significant differences in HbA1c reduction between the two groups ( P = .967 and .674 at three- and six-month follow-up). Majority of participants in both groups had high program satisfaction (telehealth 98.7% vs on-site 95.1%, P = .269). In conclusion, DSMES delivered via telehealth is as effective in lowering HbA1c as that delivered in-person, with a high satisfaction rate.

The Impact of Telemedicine-Augmented Integrated Personalized Diabetes Management on Glycemic Control in Adults With Diabetes Mellitus During the COVID-19 Pandemic: A Retrospective Study

“…Compared with a prior study in Thailand, our study demonstrated consistent results with Areevut et al 7 about the value of telemedicine in improving HbA1C levels at 3- to 6-month periods and more benefits at 12 months. However, another previous study did not show significant reductions in HbA1C.…”

“…However, there are conflicting results regarding the efficacy of hemoglobin A1C (HbA1C) reduction. 6,7 Moreover, there is a knowledge gap regarding the long-term efficacy of telemedicine for individuals with distinct types of diabetes and its implementation in vulnerable groups such as elderly patients. This study was conducted to evaluate the effectiveness of telemedicine, coupled with integrated personalized diabetes management, on glycemic control in adults with diabetes during the pandemic.…”

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

“…At the 6-month follow-up, the reductions in HbA1c in the tele-health program and the in-person program were 1.28 ± 0.16% and 1.18 ± 0.15%, respectively. 70 A recent review reported that telemedicine counseling was more effective than conventional counseling in reducing HbA1c levels in patients with diabetes in five of nine studies included in the review. 68 Similarly, a scoping review of studies assessing the impact of telemedicine on self-care processes and therapeutic outcomes in patients with diabetes in the United States reported positive outcomes in terms of glycemic control, adherence to medications, blood glucose monitoring, and other self-care practices.…”

Acceptability of telemedicine for follow up after contraceptive implant initiation at an obstetrics and gynecologic training center

“…In a retrospective study examining the implementation of telemedicine as a new approach to postpartum care in Thailand during the COVID-19 pandemic, revealed that postpartum contact increased from 48.0 to 64.6% following the introduction of telemedicine [ 24 ]. As well as the study comparing telemedicine-delivered diabetes self-management education with in-person sessions in Thailand, participants in the telehealth group reported high satisfaction levels similar to those in the in-person visit group [ 25 ]. This suggests that Thais have accepted telemedicine as an alternative for follow-up care.…”