From the Guidelines
Virtual consultations will become a cornerstone of chronic disease management, offering significant benefits while complementing in-person care. The most recent and highest quality study, 1, published in 2023, found that digital health interventions increased objectively measured physical activity and physical function in people with chronic conditions, with a standardized mean difference of 0.29 and 0.36, respectively. This study suggests that virtual consultations can be an effective way to manage chronic diseases, such as hypertension, diabetes, and heart failure, by remotely monitoring patient metrics and adjusting medication regimens as needed.
Some of the key benefits of virtual consultations in chronic disease management include:
- Improved access to care for rural patients
- Reduced transportation barriers for elderly or disabled individuals
- More frequent touchpoints without overwhelming healthcare facilities
- Enhanced patient engagement and self-management through remote monitoring and education
- Better coordination of care across specialties through integration with electronic health records
The future model of chronic disease management will likely be a hybrid approach, with initial diagnoses and comprehensive assessments conducted in-person, and routine follow-ups and medication adjustments handled virtually. This approach will allow clinicians to track patient metrics in real-time, identify concerning trends before they become emergencies, and adjust treatment plans accordingly. For example, for conditions like hypertension, virtual follow-ups can effectively monitor medication adjustments, such as titrating lisinopril from 10mg to 20mg daily, without requiring office visits for stable patients.
The technology will continue to evolve to include more sophisticated biometric monitoring, secure patient portals for asynchronous communication, and integration with electronic health records to provide seamless care coordination across specialties. As noted in 1, telehealth interventions can continuously monitor patients with chronic conditions, and may include anything from structured telephone support to remote monitoring of implantable devices. Additionally, 1 highlights the importance of self-management support and patient education in chronic disease management, which can be effectively delivered through virtual consultations. Overall, the evidence suggests that virtual consultations will play a critical role in the future of chronic disease management, and will be essential for improving patient outcomes and reducing healthcare costs.
From the Research
Virtual Consultations in Chronic Disease Management
- Virtual consultations have emerged as a promising approach for managing chronic diseases, particularly in the context of the COVID-19 pandemic 2.
- Studies have shown that virtual group visits (VGVs) can be an effective tool for preventing and managing chronic disease, with potential benefits including improved quality and reach of chronic disease prevention and management strategies 2.
- Telehealth has also been found to be a useful supplement or adjunct to in-person care for managing chronic conditions such as congestive heart failure and type 2 diabetes mellitus 3.
Effectiveness of Virtual Consultations
- Research has demonstrated that virtual consultations can be equally effective as face-to-face care for managing certain conditions, including mental illness, excessive smoking, and alcohol consumption 4.
- Virtual consultations may also reduce waiting times, lower patient costs, and reduce rates of follow-up in secondary and tertiary care settings 4.
- However, there is limited evidence on the impact of virtual consultations on clinical safety, equity, and patient-centeredness, highlighting areas for future research 4.
Remote Patient Monitoring
- Remote patient monitoring (RPM) has been found to be an effective way to improve patient care through digitally transmitted health-related data, allowing for early detection of disease decompensation and intervention 5.
- RPM has been shown to be particularly useful for managing cardiovascular disease, with wireless devices or smartphone apps being the most popular strategy 5.
- However, there is a need for more research on the use of RPM in other areas, such as postoperative care and surgical pathologies 5.
Management of Chronic Conditions
- The management of chronic conditions such as hypertension in type 2 diabetes mellitus requires careful consideration of blood pressure goals, choice of agents, and setting priorities in diabetes care 6.
- Studies have shown that treatment of hypertension in type 2 diabetes provides dramatic benefits, with target diastolic blood pressures of less than 80 mm Hg appearing optimal 6.
- Thiazide diuretics, angiotensin-II receptor blockers, and ACE inhibitors may be the preferred first-line agents for treatment of hypertension in diabetes, although other agents may also be necessary 6.