Impact of Telehealth Interventions on Medication Adherence for Patients With Type 2 Diabetes, Hypertension, and/or Dyslipidemia: A Systematic Review

Abstract

Objective: To describe telehealth interventions and determine their effect on medication adherence for patients with type 2 diabetes, hypertension, and/or dyslipidemia. Data Sources: PubMed/MEDLINE, EMBASE, Cochrane, CINAHL Plus, PsycINFO, Academic Search Ultimate, International Pharmaceutical Abstracts, Scopus, Web of Science, WHO Global Index Medicus, association websites, and gray literature were searched from January 1, 1998, to December 31, 2019. Study Selection and Data Extraction: Eligible studies reported eHealth, mobile health, and telehealth interventions for adult patients prescribed medications for chronic condition management (eg, type 2 diabetes, hypertension, and/or dyslipidemia). Studies were required to evaluate medication adherence outcomes (eg, medication possession ratio [MPR], proportion of days covered (PDC)]. Randomized controlled trials, cohort studies, and controlled before-and-after studies were included. Multiple reviewers independently extracted data and evaluated risk of bias. Data Synthesis: Of 8693 studies identified, 13 reported either an MPR or PDC and were included in the systematic review. The systematic review demonstrated that electronic health (eHealth) and telehealth interventions were successful at improving medication adherence, whereas mobile health interventions did not improve medication adherence. Relevance to Patient Care and Clinical Practice: This systematic review highlighted the available research and findings of studies assessing interventions to improve medication nonadherence among patients with type 2 diabetes, hypertension, and/or dyslipidemia. The evaluated findings lend support to the need for targeted medication adherence interventions based on patient population and practice settings. Conclusions: Telehealth modalities include telephonic outreach and specialized tools designed to increase health literacy. eHealth and telehealth medication adherence interventions were associated with improved MPR and/or PDC rates.

Mobile Health–Based Thermometer for Monitoring Wound Healing After Endovascular Therapy in Patients With Chronic Foot Ulcer: Prospective Cohort Study

“…Patients with diabetes and chronic foot ulcers exhibit poor prognoses in terms of cardiovascular outcomes; telehealth care can be used to provide comprehensive medical treatment beyond wound treatment alone. A previous study [ 28 ] has shown that telehealth care exerts positive effects in terms of disease control, including for hypertension, dyslipidemia, and diabetes, all of which are important predisposing factors for chronic foot ulcer, but chronic foot ulcer is strongly associated with concomitant cardiovascular disease, and therefore, its presence poses an increased risk of cardiovascular events [ 29 ]. In a previous study [ 30 ], we found that patients with cardiovascular disease who were receiving telehealth care had improved clinical outcomes.…”

General Medicine in the Time of Coronavirus Disease 2019 (Covid-19) and Beyond: Is it Falling Apart, Changing or Reinforcing? The Theory of the Braid Group

“…Probably, the first visits and the visits that are repeated several times for the same problem that is not well understood by the doctor, would be two situations that would require faceto-face visits. Older patients may have more difficulties than younger ones, and these can easier to have the perception of being 'abandoned', and more not indicated drug prescriptions, including antibiotics, can be made [38][39][40][41].…”

American Association of Clinical Endocrinology Clinical Practice Guideline: The Use of Advanced Technology in the Management of Persons With Diabetes Mellitus

“…265e267 Other studies have demonstrated in persons with both T1D and T2D that telemedicine is associated with improvements in A1C, 184,268e279 reductions in diabetes-related distress, 280 and improvements in medication adherence. 281 The use of telemedicine also has been associated with improved measures of engagement in diabetes self-management among younger individuals with T1D. 282 A 2016 RCT reported lower body fat and improved lipids in its group assigned to telemedicine visits, 274 and the use of telemedicine in women with GDM in a recent RCT resulted in lower A1C, better engagement, and less maternal weight gain.…”