Using telemedicine to support care for people with type 2 diabetes mellitus: a qualitative analysis of patients' perspectives.

Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE

Original Publication: [London] : BMJ Publishing Group Ltd, 2011-

Self Care* ; Telemedicine*; Diabetes Mellitus, Type 2/*epidemiology; Age Factors ; Attitude to Computers ; Computer Security ; Confidentiality ; Costs and Cost Analysis ; Female ; Focus Groups ; Humans ; Information Dissemination ; Internet Access ; Interviews as Topic ; Malaysia/epidemiology ; Male ; Middle Aged ; Personal Autonomy

Objective: Telemedicine has been promoted as an economical and effective way to enhance patient care, but its acceptance among patients in low-income and middle-income countries is poorly understood. This study is aimed to explore the experiences and perspectives of people with type 2 diabetes mellitus that used telemedicine to manage their condition.
Design: In-depth and focus group interviews were conducted with participants who have engaged in telemedicine. Questions included were participants' perception on the programme being used, satisfaction as well as engagement with the telemedicine programme. All interviews and focus groups were audio-recorded and transcribed verbatim. Data were analysed using a thematic approach.
Participants and Setting: People with type 2 diabetes (n=48) who participated in a randomised controlled study which examined the use of telemedicine for diabetes management were recruited from 11 primary care clinics located within the Klang Valley.
Results: Twelve focus groups and two in-depth interviews were conducted. Four themes emerged from the analysis: (1) generational difference; (2) independence and convenience, (3) sharing of health data and privacy and (4) concerns and challenges. The main obstacles found in patients using the telemedicine systems were related to internet connectivity and difficulties experienced with system interface. Cost was also another significant concern raised by participants. Participants in this study were primarily positive about the benefits of telemedicine, including its ability to provide real-time data and disease monitoring and the reduction in clinic visits.
Conclusion: Despite the potential benefits of telemedicine in the long-term care of diabetes, there are several perceived barriers that may limit the effectiveness of this technology. As such, collaboration between educators, healthcare providers, telecommunication service providers and patients are required to stimulate the adoption and the use of telemedicine.NCT0246680.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Diabetes Res Clin Pract. 2018 Aug;142:173-187. (PMID: 29857093)
BMJ. 2000 Jun 3;320(7248):1517-20. (PMID: 10834899)
Diabet Med. 2015 Dec;32(12):1658-61. (PMID: 26103794)
Diabetes Care. 2013 Jan;36(1):176-8. (PMID: 23264289)
J Telemed Telecare. 2013 Feb;19(2):89-94. (PMID: 23532005)
Sci Rep. 2017 Oct 4;7(1):12680. (PMID: 28978949)
BMC Health Serv Res. 2016 Sep 29;16(1):524. (PMID: 27683021)
J Gen Intern Med. 2002 Apr;17(4):243-52. (PMID: 11972720)
Diabetes Care. 2016 Jan;39 Suppl 1:S39-46. (PMID: 26696679)
Sci Rep. 2017 Aug 31;7(1):10119. (PMID: 28860546)
Medicine (Baltimore). 2016 Jan;95(2):e2457. (PMID: 26765440)
Scand J Caring Sci. 2018 Mar;32(1):24-44. (PMID: 28771752)
J Med Internet Res. 2016 May 16;18(5):e97. (PMID: 27185295)
Soc Sci Med. 2018 Feb;198:139-147. (PMID: 29335160)
BMJ. 2012 Feb 27;344:e486. (PMID: 22371867)
J Telemed Telecare. 2018 Jan;24(1):4-12. (PMID: 29320966)
Eur Respir J. 2003 Jan;21(1):58-67. (PMID: 12570110)
J Eval Clin Pract. 2007 Apr;13(2):242-53. (PMID: 17378871)
J Particip Med. 2018 Dec 19;10(4):e11089. (PMID: 33052117)
Diabetes Care. 2007 Jun;30(6):1370-3. (PMID: 17363757)
Diabetes Care. 2011 Feb;34(2):262-7. (PMID: 21270183)
Diabetes Technol Ther. 2018 Jul;20(7):492-500. (PMID: 29812965)
Diabetes Care. 2015 Sep;38(9):1627-33. (PMID: 26294772)
Int J Behav Med. 2015 Jun;22(3):277-82. (PMID: 26001382)
J Gen Intern Med. 2020 Jan;35(1):87-94. (PMID: 31512187)
Telemed J E Health. 2017 Jun;23(6):527-532. (PMID: 27911667)
Diabet Med. 2020 Dec;37(12):1966-1976. (PMID: 31631398)
Front Pharmacol. 2017 May 30;8:330. (PMID: 28611672)
Cochrane Database Syst Rev. 2012 Jan 18;1:CD005060. (PMID: 22258959)
Diabetes Res Clin Pract. 2012 May;96(2):149-55. (PMID: 22265215)
Diabetes Res Clin Pract. 2017 Jun;128:40-50. (PMID: 28437734)
J Med Internet Res. 2010 Jun 16;12(2):e21. (PMID: 20554500)
J Gen Intern Med. 2016 Mar;31(3):269-75. (PMID: 26269131)
BMJ Open. 2017 Aug 3;7(8):e016242. (PMID: 28775188)
J Med Internet Res. 2016 May 30;18(5):e140. (PMID: 27241876)
BMJ Open. 2016 Sep 02;6(9):e010524. (PMID: 27591016)
BMJ Open. 2016 Mar 02;6(3):e009750. (PMID: 26936904)
J Am Med Inform Assoc. 2007 May-Jun;14(3):269-77. (PMID: 17329725)

Keywords: barriers; diabetes; patient perspective; qualitative; telemedicine

ClinicalTrials.gov NCT02466880

Date Created: 20191024 Date Completed: 20201020 Latest Revision: 20240721

20240721

PMC6830613

10.1136/bmjopen-2018-026575

31640990