Telehealth for the management of patients with type 2 diabetes in remote areas of Taiwan: a best practice implementation project

Shwu-Feng Tsay; Hsiu-Chun Chang; Pei-Fan Mu; Pei-Lin Chou; Yu-Chu Lin; Jin-Hung Lin

doi:10.1097/XEB.0000000000000519

Telehealth for the management of patients with type 2 diabetes in remote areas of Taiwan: a best practice implementation project

JBI Evid Implement. 2025 Jul 4. doi: 10.1097/XEB.0000000000000519. Online ahead of print.

Authors

Shwu-Feng Tsay^{1

2

3

4}, Hsiu-Chun Chang⁵, Pei-Fan Mu^{1

6}, Pei-Lin Chou⁷, Yu-Chu Lin⁸, Jin-Hung Lin^{1

5

9

10}

Affiliations

¹ JBI Taiwan Center for Holistic Care and Evidence Implementation.
² Department of Health Services Administration, College of Public Health, China Medical University, Taichung, Taiwan.
³ School of Nursing, National Taiwan University, Taipei, Taiwan.
⁴ Department of Nursing and Health Care, Ministry of Health and Welfare, Taipei, Taiwan.
⁵ Public Health Bureau, Pingtung County Government, Pingtung, Taiwan.
⁶ Institute of Clinical Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan.
⁷ Laiyi Township Health Center, Pingtung, Taiwan.
⁸ China Medical University Hospital, Taichung, Taiwan.
⁹ Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan.
¹⁰ School of Public Health, National Defense Medical Center, Taipei, Taiwan.

PMID: 40607731
DOI: 10.1097/XEB.0000000000000519

Abstract

Introduction: Telehealth services integrate technology with specialized medical care, and can be used to improve blood sugar management and reduce complications in patients with type 2 diabetes.

Objectives: This study aimed to improve telemedicine care for patients with type 2 diabetes in public health centers in remote Indigenous communities in Taiwan through evidence-based practices. This included increasing the rates of ophthalmic examinations and enhancing the capacity of health care providers.

Methods: This project followed the JBI Evidence Implementation Framework and was supported by the JBI Practical Application of Clinical Evidence System (PACES). Baseline and follow-up audits were conducted among health care providers and patients with type 2 diabetes to measure compliance with best practices and determine any improvements in practice after implementation. HbA1c levels in patients with type 2 diabetes were analyzed using paired sample t-tests, with statistical significance set at p < 0.05.

Results: The follow-up audit revealed that compliance rates for the six audit criteria improved, with Criteria 1-5 increasing from 62.5% to 87.5% or 100%. Additionally, Criterion 6 improved from 37.5% to 62.5%. The HbA1c values of the patients showed pre- and post-intervention means of 7.8291% and 7.3236%, respectively.

Conclusions: Using a coaching leadership model along with JBI audit criteria to enhance the knowledge and skills of health care providers was essential for the success of the project. This approach resulted in significant advancements in caring for people with type 2 diabetes.

Spanish abstract: http://links.lww.com/IJEBH/A377.

Keywords: community health services; evidence-based practice; telehealth; translational research; type 2 diabetes mellitus.