Systematic review of the effectiveness of telehealth diabetes management programme in improving diabetes care and its applicability to Hong Kong

Abstract

Background Telehealth is a communication technology that allows exchange of data between patients and health care providers. Disease management is a structured multifaceted intervention to patient care that promotes self-management skills and improves patient-doctor communication. This systematic review aims to determine the effectiveness of “telehealth diabetes management programmes” for patients with type-2 diabetes (T2DM) in improving outcomes such as glycaemic control, diabetes related mortality, hospital admissions and overall cost-effectiveness of programme. Its applicability to Hong Kong will be reviewed.

Methods A literature search of electronic bibliographic databases was performed to identify relevant articles. Both randomised control trials and observational studies on patients with T2DM published up to March 2013 were included in the analysis.

Results A total of 14 articles were eligible (n=9708 subjects). Eight were randomised controlled trials and six observational studies. Ten studies reported on mean change in HbA1c level, three on health care utilization and three on cost-effectiveness of telehealth management programme. No studies had diabetes related mortality as their outcome measure. Across these trials, telehealth diabetes management programme resulted in an improvement in glycaemic control, likely reduction in health service utilization and a probable cost-effective programme.

Discussions The current Hong Kong’s health care system faces challenges from long wait-list for medical consultations and rising health care costs. The applicability of the results from this review to the setting in Hong Kong, and feasibility of implementation will be discussed.

Conclusion Telehealth disease management programmes had clinically modest but significant improvement in HbA1c among adults with T2DM and likely to be cost-effective. The results of this review have potential important implications for policy makers in the allocation of health care resources.