- Autores: Jorge César Correia, Hafsa Meraj, Soo Huat Teoh, Ahmed Waqas, Maaz Ahmad, Luís Velez Lapão, Zoltan Patakya & Alain Golay
- Ano de Publicação: 2021
- Journal: Bulletin of the World Health Organization
Diabetes mellitus is one of the most prevalent chronic and preventable conditions affecting over 415 million people globally, and accounted for over 5 million deaths in 2015. Because the symptoms of diabetes affect both the micro- and macrovascular systems, the disease is associated with significant morbidity, mortality and a poor quality of life. By 2030, the estimated annual medical and related costs of both type 1 and type 2 diabetes in the United States of America alone will reach a staggering 622 billion United States dollars (US$). Over 75% of patients with diabetes live in low- and middle-income countries, where most patients obtain diabetes treatment only after making out-of-pocket payments. A study reported the costs of diabetes treatment as US$ 7 per visit for an outpatient, US$ 290 per year for an inpatient, an US$ 25 and US$ 177 per patient per year for laboratory and medication costs, respectively.
In sub-Saharan Africa, recent studies estimate the financial burden related to diabetes as US$ 19.5 billion, about 1.2% of the cumulative regional gross domestic product. The prevalence of diabetes in low- and middle-income countries has risen faster than in high-income countries, with the highest rise observed in the Eastern Mediterranean Region.
The prevalence of diabetes is highest in low- and middle-income countries (12.3%) followed by upper-middleincome countries (11.1%), and lowest in high-income countries (6.6%). This high prevalence in low- and middle-income countries, coupled with a lack of both quality health-care services and equity in health care, means that the long-term management of diabetes is a major global challenge.
It is often opined that these inequalities in diabetes care, as well as inequities in health-care services and slow progress towards achievement of universal health coverage, could be addressed by employing telemedicine-based interventions. Telemedicine is the practice by which telecommunication and information technology are used to provide clinical health care to distant patients. In a broader context, digital health interventions can help stakeholders to overcome several health systems challenges.
These challenges include an insufficient supply of commodities, poor adherence to guidelines by health-care professionals, poor adherence to treatment by patients, a lack of access to information or data, and a loss of patients to follow-up. Combined with decision support systems, telemedicine can help by providing protocol checklists, providing prompts and alerts as per protocols, enhancing communication between health-care providers and patients, and compiling the schedules of health-care providers. Telemedicine can also aid in routine health-care data collection by increasing the use of electronic medical records and health management information systems.
Several telemedicine interventions targeting diabetes have been implemented in low- and middle-income countries; however, evidence synthesis efforts in such settings are scarce.