The Effectiveness of Telemedicine in the Management of Chronic Diseases (Diabetes, Hypertension, and Coronary Heart Disease) at Primary Care Facilities in Eastern Trinidad During the COVID-19 Pandemic.

Introduction: During the COVID-19 pandemic, Trinidad and Tobago's government implemented lockdowns and limited the availability of outpatient clinics to curb virus transmission. Subsequently, telemedicine via telephone calls was utilized to address infection control and continuity of care for chronic disease patients. Methods: An observational study was conducted at three primary care facilities in Eastern Trinidad using convenience sampling to review retrospectively telemedicine patients' medical records from October 2019 to February 2020 (before telemedicine) and from March 2020 to September 2020 (during telemedicine) for comparative analysis. Data were analyzed using IBM SPSS Statistics 28.0 software and Microsoft Excel. Results: A total of 199 patient files were analyzed; 57.3% of these were female; 52.3% were 60 years and older. A Wilcoxon signed-rank test demonstrated no statistically significant differences between random blood sugar (RBS) readings (0.355), weight (0.621), or systolic and diastolic blood pressure (BP; 0.239 and 0.232, respectively) before and during the 6-month period of telemedicine consultation. Patients compliant with medication before the use of telemedicine were 14 times more likely to attain target BPs. There was no significant association between compliance with prescribed therapy and BP control (0.335) during the period of telemedicine. Discussion: The findings support the use of telemedicine to manage chronic diseases such as hypertension, diabetes mellitus, and coronary heart disease, as the standard of care was preserved, and no inferiority of recorded outcomes was demonstrated. Although there was an overall decrease in compliance during the telemedicine period compared with before, comparative analysis exhibited no statistically significant differences in BP or RBS readings.

The effectiveness of Telemedicine on the Management of Chronic Diseases (Diabetes, Hypertension and Coronary Heart Disease) at ERHA Primary Health Care Facilities during the COVID-19 pandemic

During the COVID-19 pandemic, Trinidad and Tobago's Government implemented lockdowns and limited outpatient clinics to curb virus transmission. For those with comorbidities (eg.DM, HTN, heart conditions), the risk of severe illness and fatality is increased'. Hence, a niche for telemedicine developed to address infection control and the continuity of care of chronic disease patients. At the ERHA, a Telemedicine initiative was introduced at primary health centres in late 2020. Hence,our group decided to perform a comparative 6 month study to analyse chronic disease outcomes and to assess the effectiveness of telemedicine.