沙特阿拉伯2019年冠状病毒病大流行期间远程医疗对2型糖尿病控制不佳患者的影响：研究结果与启示
The impact of telemedicine on patients with uncontrolled type 2 diabetes mellitus during the COVID-19 pandemic in Saudi Arabia: Findings and implications.
作者信息
M Tourkmani Ayla, J ALHarbi Turki, Rsheed Abdulaziz M Bin, Alrasheedy Alian A, ALMadani Wedad, ALJuraisi Fahad, AlOtaibi Azzam Fahad, AlHarbi Mohammed, AlAbood Abood F, Alshaikh Abdulaziz A Ibn
机构信息
Chronic Illness Center, Family and Community Medicine Department, Prince Sultan Military Medical City, Saudi Arabia.
Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraidah, Saudi Arabia.
出版信息
J Telemed Telecare. 2023 Jun;29(5):390-398. doi: 10.1177/1357633X20985763. Epub 2021 Feb 1.
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; <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.
引言
在新冠疫情期间，由于封锁、取消面对面就诊以及患者对前往诊所就诊时被感染的恐惧等预防措施，常规糖尿病护理发生了变化。由于疫情，实施了虚拟诊所来提供糖尿病护理。因此，我们开展了这项研究，以评估这些虚拟诊所在2型糖尿病（DM）高危患者中对血糖控制的影响。
方法
在沙特阿拉伯利雅得一家家庭和社区医学系慢性病中心的虚拟综合护理诊所，对130例2型糖尿病患者进行了一项前瞻性单队列远程医疗护理干预前后对照研究，研究时间为新冠疫情期间。
结果
参与者的平均年龄为57岁（标准差（SD） = 12），糖尿病平均（SD）病程为14（7）年。在4个月的时间里，糖化血红蛋白（HbA1c）从干预前的9.98±1.33显著降至干预后的8.32±1.31（平均差异1.66±1.29；CI = 1.43 - 1.88；<0.001）。此外，大多数面对面护理就诊被成功替代，因为大多数患者（64%）在4个月期间仅需要一或两次面对面就诊，而在疫情前该高危患者组的综合护理项目中通常每1 - 2周就诊一次。
讨论
当前研究发现，在新冠疫情期间，远程医疗护理对糖尿病高危患者的血糖控制有显著的积极影响。此外，研究表明远程医疗可融入糖尿病护理，成功替代许多常规的面对面护理就诊。因此，沙特阿拉伯的卫生政策制定者需要考虑制定远程医疗护理的综合指南，以确保护理质量，并解决诸如财务报销和患者信息隐私等问题。
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