The impact of telemedicine on patients with uncontrolled type 2 diabetes mellitus during the COVID-19 pandemic in Saudi Arabia: Findings and implications

Abstract

Introduction Routine diabetes care changed during the COVID-19 pandemic due to precautionary measures such as lockdowns, cancellation of in-person visits, and patients’ fear of being infected when attending clinics. Because of the pandemic, virtual clinics were implemented to provide diabetes care. Therefore, we conducted this study to assess the impact of these virtual clinics on glycaemic control among high-risk patients with type 2 diabetes mellitus (DM). Methods A prospective single-cohort pre-/post telemedicine care intervention study was conducted on 130 patients with type 2 DM attending a virtual integrated care clinic at a chronic Illness center in a family and community medicine department in Riyadh, Saudi Arabia during the COVID-19 pandemic. Results The mean age of the participants was 57 years (standard deviation (SD) = 12) and the mean (SD) duration of diabetes was 14 (7) years. Over a period of 4 months, the HbA1c decreased significantly from 9.98 ± 1.33 pre-intervention to 8.32 ± 1.31 post-intervention (mean difference 1.66 ± 1.29; CI = 1.43–1.88; P <0.001). In addition, most in-person care visits were successfully replaced, as most patients (64%) needed only one or two in-person visits during the 4-month period, compared with typically one visit every 1–2 weeks in the integrated care programme before the pandemic for this group of high-risk patients. Discussion The current study found a significant positive impact of telemedicine care on glycaemic control among high-risk patients with DM during the COVID-19 pandemic. Moreover, it showed that telemedicine could be integrated into diabetic care to successfully replace many of the usual in-person care visits. Consequently, health policy makers need to consider developing comprehensive guidelines in Saudi Arabia for telemedicine care to, ensure the quality of care and address issues such as financial reimbursement and patient information privacy.

Telepharmacy: A Potential Alternative Approach for Diabetic Patients During the COVID-19 Pandemic

“…For the majority of patients (64%), only one or two visits were required during the 4-month study period. 32 …”

“…Research on the use of telepharmacy for diabetic patients during the COVID-19 pandemic is still very limited. The only study results the authors obtained were Tourkmani et al 32 The study showed positive results with the provision of interventions by a multidisciplinary team led by pharmacists. Another study on the use of telepharmacy during the COVID-19 pandemic in outpatients is conducted by Poderoso et al 38 showed that the patients get clinical follow-up and therapeutic adherence monitoring with free home delivery of medication reducing outpatient visits by 56%, the average patient visit before the pandemic was 215 ± 25 and the average visit during a pandemic after telepharmacy implemented was 95 ± 29.…”

“…Telepharmacy is effective in providing care for DM patients, especially during the COVID-19 pandemic when direct care is not possible. However, based on the results of the study, 32 several factors must be considered for the success of pharmaceutical services. First, there must be good regulation and coordination between all health workers and the parties involved.…”

COVID-19 among people with diabetes mellitus in Saudi Arabia: Current situation and new perspectives

“…Thus, in such situations in the future, technology and telemedicine should be used to fill the gaps when the healthcare system is overloaded [ 58 , 73 ]. A recent study from Saudi Arabia stated a significant progressive effect of telemedicine care on glycaemic control among high-risk patients with diabetes during the COVID-19 pandemic [ 74 ]. As of August 2020, a report indicated that almost 60,000 patients with diabetes benefitted from remote consultation in Saudi Arabia [ 75 ].…”

Cost-effectiveness of telemedicine care for patients with uncontrolled type 2 diabetes mellitus during the COVID-19 pandemic in Saudi Arabia

“…[30][31][32] Before the pandemic, many studies indicated the clinical effectiveness of telemedicine in diabetes care, including significant and clinically relevant reductions in HbA1c. [31][32][33][34][35][36][37][38] Moreover, during the COVID-19 pandemic, two studies from Japan 39 and Saudi Arabia 40 reported similar positive clinical outcomes in terms of glycemic control. In addition, it has been shown that increasing patient contact through frequent phone calls improves patient therapy adherence, motivation, and metabolic control.…”