Effectiveness of Telemedicine in the Management of Inmates with Diabetes and Hypertension in Correctional Facilities in Buriram Province

Abstract

Objectives: This study aimed to evaluate the effectiveness of telemedicine in the management of inmates with hypertension and diabetes mellitus in Correctional Facilities in Buriram Province. Methods: A quasi-experimental study was conducted. The intervention group consisted of incarcerated patients who received telemedicine services, while the control group received usual care. Systolic and diastolic blood pressure, and fasting capillary blood glucose levels were monitored at baseline, 2 and 4 months. The effectiveness of telemedicine was analyzed using multivariable linear and logistic regressions. A generalized estimating equation (GEE) was also utilized. Results were presented as mean differences (MD), Adjusted OR (AdjOR), 95% confidence intervals (95% CI), and p-value. Results: Of 40 incarcerated patients with hypertension and/or diabetes mellitus were enrolled and equally divided into the intervention and control groups (20 participants per group). No significant differences in baseline characteristics were observed between the two groups. Telemedicine significantly reduced systolic blood pressure at the 4-month follow-up, while a significant difference in diastolic blood pressure between the two groups was observed at the 2-month follow-up. However, there was no significant difference in fasting capillary blood glucose levels throughout the study period. Overall, telemedicine significantly reduced both systolic and diastolic blood pressure compared with usual care (MD = −12.87 [−21.77, −3.97] and MD = −9.64 [−14.55, −4.73], respectively) and introduced well blood pressure control (p-value = 0.005), Nevertheless, it demonstrated comparable effectiveness in reducing fasting capillary blood glucose levels (p-value = 0.895). Conclusion: Telemedicine was more effective than usual care in reducing blood pressure among incarcerated patients with hypertension, while providing comparable effectiveness in controlling fasting capillary blood glucose levels among those with diabetes mellitus. Telemedicine services may therefore serve as an alternative approach for managing chronic diseases in incarcerated populations, enhancing equity in access to healthcare services and improving quality of life among them.