Authors (including presenting author) :
Cheung SM, Lam YH, Huang HY, Ho SY, Liu WSA, Au KYS, Lam YFD, Ng ML, Pang HK, Lau YFE
Affiliation :
Diabetes Ambulatory Center, Department of Medicine, Pamela Youde Nethersole Eastern Hospital
Keyword 2: :
Effectiveness
Introduction :
As healthcare continues to evolve, the traditional mode of in-person diabetes (DM) self-care education has encountered significant challenges. Many patients, particularly those in the working population, struggle to attend clinic sessions. This reluctance has been further intensified by the current economic conditions, resulting in decreased participation in essential health education programs. In contrast, telehealth service has emerged as a transformative solution. Evidence supports that telehealth enhances convenience, saves time, and improves access to healthcare services. In recent years, our DM nurse clinic has started to provide telehealth service to patients with diabetes. This study aims to evaluate the effectiveness of diabetes telehealth education to improve glycemic control and patient experience with the telehealth service in diabetes nurse clinics.
Objectives :
To improve hemoglobin A1c (HbA1c) of patients with diabetes through DM telehealth nurse clinic. To enhance patient experience in attending DM nurse clinic follow-up. To enhance nurse clinic attendance rate.
Methodology :
Patients with diabetes attend Metabolic Risk Assessment (MRA) regularly. After the MRA, instead of in-person DM reinforcement class, a DM Telehealth Nurse Clinic follow-up was arranged for eligible patients. Patients who attended DM Telehealth Nurse Clinic from January to April 2025 were recruited in this study. The effectiveness of the DM Telehealth Nurse Clinic was evaluated by comparing the changes in HbA1c (HbA1c before attending the DM Telehealth Nurse Clinic follow-up versus HbA1c within 6 months after attending the DM Telehealth Nurse clinic follow-up) . Patient experience with the telehealth service was evaluated by using a validated Telemedicine Satisfaction Questionnaire (TSQ), with permission obtained to use this instrument, in May 2025. The highest possible score of the questionnaire was 70. The higher the score, the higher the satisfaction level. Also, comparison of the attendance rate between DM Telehealth Nurse Clinic and traditional in-person DM reinforcement class were done.
Result & Outcome :
There were 30 patients attending DM telehealth nurse clinics from January to April 2025. Their average age was 50.77 ± 14.38 years old and average duration of diabetes was 9.80 ± 7.42 years. Fifteen of them were male. Only one of them belonged to type 1 DM and the others were type 2 DM. The majority of them, 80%, were the working group. The mean HbA1c has statistically significant improvement from 7.53 ± 1.46% to 6.99 ±1.09% (p=0.01) after the patients had attended the DM telehealth nurse clinic follow-up. 25 out of the 30 patients completed the TSQ survey. Patients reported a high level of satisfaction. The mean total score of the questionnaire was 63.60 ± 6.63. Among the 14 questions in TSQ, Q9 “Telemedicine saves me time traveling to hospital or a specialist clinic” got the highest average score 4.88 ± 0.33 while Q8 “I obtain better access to health-care services by use of telemedicine” got the lowest average score 4.08 ± 0.86. After analyzing the data, it was found that older patients tend to give lower scores on Q8. On the other hand, the attendance rate of DM telehealth nurse clinics was 88%, which was much higher than in-person DM nurse clinics, 79%. The results of a significant improvement in HbA1c, a high satisfactory rate and better attendance rate showed that telehealth service is effective in diabetic management and is highly acceptable to patients with diabetes.
