Outcomes of Telehealth Monitoring on Glycemic Control and Patient-Reported Results in Poorly Controlled Type 2 Diabetes: A Value-Based Healthcare Approach at Wiang Pa Pao Hospital, Chiang Rai
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Abstract
Type 2 diabetes mellitus (T2DM) is a major public health problem worldwide. Many patients fail to achieve adequate glycemic control, leading to serious complications and increased healthcare costs. Telehealth monitoring has emerged as an innovative approach to enhance self-management, continuity of care, and patient engagement, aligning with the principles of value-based healthcare (VBHC).
Objective
To evaluate the effects of telehealth monitoring on glycemic control, health behaviors, patient-reported outcomes (PROMs), patient-reported experience measures (PREMs), and health economic outcomes among patients with poorly controlled type 2 diabetes mellitus.
Methods
This quasi-experimental study was conducted among 128 patients with poorly controlled T2DM (HbA1c > 7.0%) attending the diabetes clinic at Wiang Pa Pao Hospital, Chiang Rai, Thailand. Participants were allocated into an experimental group receiving standard care plus smartphone-based telehealth monitoring (n = 64) and a control group receiving standard care alone (n = 64). Outcomes included fasting blood sugar (FBS), HbA1c, diabetes-related complications, self-care behaviors, quality of life (EQ-5D), mental well-being (WHO-5), patient experience (Telehealth Usability Questionnaire and Net Promoter Score), and healthcare utilization. Data were analyzed using independent t-tests and Poisson regression.
Results
Baseline characteristics and clinical parameters were comparable between the two groups. After 6 months, the experimental group demonstrated significantly lower FBS levels at 2, 4, and 6 months compared with the control group is 121.0 ± 33.4 vs. 146.0 ± 30.6 mg/dL at 6 months (p<0.001). Mean HbA1c at 6 months was significantly lower in the experimental group than in the control group is 7.34 ± 1.13% vs. 8.59 ± 0.98% (p < 0.001). Dietary control adherence was significantly higher in the experimental group at months 2, 4, and 6, while physical activity and medication adherence did not differ significantly between groups. No significant differences were observed in diabetes-related complications, PROMs, or healthcare costs. Most participants in the experimental group reported high usability and positive experiences with the telehealth system.
Conclusion and Discussion
Telehealth monitoring combined with standard care significantly improved glycemic control and dietary adherence among patients with poorly controlled T2DM, without increasing healthcare utilization or costs. Although no significant differences were observed in quality of life measures, patients reported high satisfaction and usability, highlighting the feasibility and acceptability of telehealth in a community hospital setting. These findings support the integration of telehealth monitoring into diabetes care as a value-based healthcare strategy, particularly for improving clinical outcomes and patient engagement.
Article Details
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