RF16 | PSUN234 The Effect of Telemedicine on the Self-Care Activities of Patients with Type 2 Diabetes Mellitus and Patient Satisfaction during the COVID-19 Pandemic at the University of Santo Tomas Hospital
Authors: Bawal Dionise Ysabelle , Cunanan Elaine , Kho Sjoberg 
Published: November 2022

Abstract

Introduction
Outpatient consultations comprise the majority of referrals in endocrinology. Patients with diabetes require constant follow-up and medication adjustments to achieve optimal glycemic targets. The COVID-19 pandemic made interruption and delays in healthcare delivery inevitable. This placed a great strain on monitoring patients with diabetes, placing greater importance on patient self-management. Telemedicine was introduced in our country to bridge the gap between physician and patient that was created by community quarantines and travel restrictions. However, our country was not ready for telemedicine as it has never been used in our healthcare system. This caused apprehension among doctors and patients as not everyone was technologically adept to understand the system. However, as months went by, telemedicine was eventually accepted as a "new normal" way of seeking medical care.

Objective
To determine if there is a difference in patient's self-care activities before and after using telemedicine using the Diabetes Self-Management Questionnaire (DSMQ)

Methodology
A descriptive cross-sectional study of patients with type 2 diabetes mellitus who consulted via telemedicine using different available platforms were included. Patients were asked to accomplish the Diabetes Self-Management Questionnaire (DSMQ) as a measure of self-care activities before and after the use of telemedicine. Clinical profile and glycemic control before and after telemedicine were secondary outcomes. With the goal of improving and tailoring telemedicine for our countrymen, patient satisfaction and opinions regarding telemedicine (i.e, accessibility, ease of use, areas to improve on) were also assessed using a patient satisfaction survey.

Results
Fifty-five patients were included in the study. An improvement in self-care practices was demonstrated by significantly higher mean DSMQ scores after telemedicine consultations (6.79 + 1.33 to 7.32 + 1.21, p = 0.0015), with dietary control and physical activity subscales obtaining the highest scores. There was a statistically significant reduction in HbA1c on follow up (8.37 + 2.31 to 7.31 + 1.36; p &lt; 0.00001). In terms of clinical profile, majority of patients had poorly controlled diabetes at baseline. Those with well-controlled diabetes (n = 14) at baseline remained to have good control while the proportion of those with poorly controlled diabetes (n = 34) showed improvement on follow up (p = 0.0045). Most patients were highly satisfied with telemedicine experience and were likely to recommend it to others and avail of the service in the future.

Conclusion
As far as we know, there has been no previously published study in our country regarding telemedicine and its effect on diabetes management. This paper showed that the use of telemedicine by patients with type 2 diabetes mellitus significantly improved both self-care practices and glycemic control. These findings, together with the positive responses in patient satisfaction, may deem it necessary that telemedicine be mainstreamed as part of diabetes care in our country.
Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m., Sunday, June 12, 2022 12:42 p.m. - 12:47 p.m.