TELEMEDICINE VS. IN-PERSON CARE IN MANAGING CHRONIC DISEASES – A META-ANALYSIS OF TREATMENT OUTCOMES IN DIGITAL HEALTHCARE SETTINGS
DOI:
https://doi.org/10.71000/c2wrpt30Keywords:
Chronic Disease, Diabetes Mellitus, Digital Health, Hypertension, Patient Satisfaction, Quality of Life, TelemedicineAbstract
Background: Chronic diseases such as hypertension, diabetes mellitus, and heart failure require consistent and long-term management. In low-resource settings like Pakistan, telemedicine has emerged as a potential solution to bridge healthcare access gaps, yet comparative evidence with in-person care remains limited.
Objective: To evaluate treatment outcomes in telemedicine versus in-person care for managing chronic diseases in digital healthcare settings in Pakistan.
Methods: A meta-analysis was conducted over eight months involving 1,240 participants equally distributed between telemedicine and in-person care groups. Studies were included based on standardized criteria focusing on adults with chronic conditions including hypertension, diabetes, heart failure, and inflammatory bowel disease. Data were extracted and analyzed using RevMan 5.4 and SPSS 27. Outcomes assessed included blood pressure, glycemic control, quality of life (EQ-5D), and patient satisfaction. Parametric statistical tests were applied, assuming normally distributed data.
Results: Telemedicine significantly reduced mean systolic (129.2 ± 7.3 mmHg) and diastolic (79.5 ± 5.8 mmHg) blood pressure compared to in-person care (132.8 ± 6.9 mmHg and 82.1 ± 5.6 mmHg, respectively; p<0.01). Glycemic outcomes were also better in the telemedicine group, with lower fasting glucose (6.8 ± 1.1 mmol/L) and HbA1c (6.5 ± 0.8%) than in-person care (7.3 ± 1.3 mmol/L and 7.1 ± 0.9%, respectively; p<0.01). Quality of life scores and satisfaction rates were higher in the telemedicine cohort (p<0.05).
Conclusion: Telemedicine demonstrated superior or comparable outcomes to in-person care in managing chronic diseases, supporting its integration into routine healthcare delivery in underserved settings.
References
Cox NS, Khor YH. Telerehabilitation in pulmonary diseases. Curr Opin Pulm Med. 2023;29(4):313-21.
Oh-Park M, Lew HL, Raghavan P. Telerehabilitation for Geriatrics. Phys Med Rehabil Clin N Am. 2021;32(2):291-305.
Cox NS, McDonald CF, Mahal A, Alison JA, Wootton R, Hill CJ, et al. Telerehabilitation for chronic respiratory disease: a randomised controlled equivalence trial. Thorax. 2022;77(7):643-51.
Cox NS, Dal Corso S, Hansen H, McDonald CF, Hill CJ, Zanaboni P, et al. Telerehabilitation for chronic respiratory disease. Cochrane Database Syst Rev. 2021;1(1):Cd013040.
Vila M, Rosa Oliveira V, Agustí A. Telemedicine in the management of chronic obstructive pulmonary disease: A systematic review. Med Clin (Barc). 2023;160(8):355-63.
Zhang K, Huang Q, Wang Q, Li C, Zheng Q, Li Z, et al. Telemedicine in Improving Glycemic Control Among Children and Adolescents With Type 1 Diabetes Mellitus: Systematic Review and Meta-Analysis. Journal of Medical Internet Research. 2023;26.
Janjua S, Carter D, Threapleton CJ, Prigmore S, Disler RT. Telehealth interventions: remote monitoring and consultations for people with chronic obstructive pulmonary disease (COPD). Cochrane Database Syst Rev. 2021;7(7):Cd013196.
Pang L, Liu H, Liu Z, Tan J, Zhou L, Qiu Y, et al. Role of Telemedicine in Inflammatory Bowel Disease: Systematic Review and Meta-analysis of Randomized Controlled Trials. Journal of Medical Internet Research. 2021;24.
Brands MR, Gouw SC, Beestrum M, Cronin RM, Fijnvandraat K, Badawy SM. Patient-Centered Digital Health Records and Their Effects on Health Outcomes: Systematic Review. J Med Internet Res. 2022;24(12):e43086.
Lee AYL, Wong AKC, Hung TTM, Yan J, Yang S. Nurse-led Telehealth Intervention for Rehabilitation (Telerehabilitation) Among Community-Dwelling Patients With Chronic Diseases: Systematic Review and Meta-analysis. J Med Internet Res. 2022;24(11):e40364.
Bekelman DB, Feser W, Morgan B, Welsh CH, Parsons EC, Paden G, et al. Nurse and Social Worker Palliative Telecare Team and Quality of Life in Patients With COPD, Heart Failure, or Interstitial Lung Disease: The ADAPT Randomized Clinical Trial. Jama. 2024;331(3):212-23.
Gonçalves-Bradley DC, AR JM, Ricci-Cabello I, Villanueva G, Fønhus MS, Glenton C, et al. Mobile technologies to support healthcare provider to healthcare provider communication and management of care. Cochrane Database Syst Rev. 2020;8(8):Cd012927.
Gerber BS, Biggers A, Tilton JJ, Smith Marsh DE, Lane R, Mihailescu D, et al. Mobile Health Intervention in Patients With Type 2 Diabetes: A Randomized Clinical Trial. JAMA Netw Open. 2023;6(9):e2333629.
Moreno-Ligero M, Moral-Munoz JA, Salazar A, Failde I. mHealth Intervention for Improving Pain, Quality of Life, and Functional Disability in Patients With Chronic Pain: Systematic Review. JMIR Mhealth Uhealth. 2023;11:e40844.
Zanaboni P, Dinesen B, Hoaas H, Wootton R, Burge AT, Philp R, et al. Long-term Telerehabilitation or Unsupervised Training at Home for Patients with Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial. Am J Respir Crit Care Med. 2023;207(7):865-75.
Saokaew S, Kanchanasurakit S, Kositamongkol C, Chaiyo K, Jirapisut T, Aomsin N, et al. Effects of Telemedicine on Obese Patients With Non-alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis. Frontiers in Medicine. 2021;8.
Sánchez-Gutiérrez C, Gil-García E, Rivera-Sequeiros A, López-Millán J. Effectiveness of telemedicine psychoeducational interventions for adults with non-oncological chronic disease: A systematic review. Journal of advanced nursing. 2022.
Han X, Chen W, Gao Z, Lv X, Sun Y, Yang X, et al. Effectiveness of telemedicine for cardiovascular disease management: systematic review and meta-analysis. Annals of palliative medicine. 2021;10 12:12831-44.
Bakitas MA, Dionne-Odom JN, Ejem DB, Wells R, Azuero A, Stockdill ML, et al. Effect of an Early Palliative Care Telehealth Intervention vs Usual Care on Patients With Heart Failure: The ENABLE CHF-PC Randomized Clinical Trial. JAMA Intern Med. 2020;180(9):1203-13.
Liu S, Li J, Wan DY, Li R, Qu Z, Hu Y, et al. Effectiveness of eHealth Self-management Interventions in Patients With Heart Failure: Systematic Review and Meta-analysis. J Med Internet Res. 2022;24(9):e38697.
Zhang W, Cheng B, Zhu W, Huang X, Shen C-Y. Effect of Telemedicine on Quality of Care in Patients with Coexisting Hypertension and Diabetes: A Systematic Review and Meta-Analysis. Telemedicine journal and e-health : the official journal of the American Telemedicine Association. 2020.
Kelly F, Moraes F, Lôbo A, Sano V, Souza MEC, De Almeida AM, et al. The effect of telehealth on clinical outcomes in patients with hypertension and diabetes: A meta-analysis of 106,261 patients. Journal of telemedicine and telecare. 2024:1357633.
Espinoza-Bravo C, Arnal-Gómez A, Martínez-Arnau FM, Núñez-Cortés R, Hernández-Guillén D, Flor-Rufino C, et al. Effectiveness of Functional or Aerobic Exercise Combined With Breathing Techniques in Telerehabilitation for Patients With Long COVID: A Randomized Controlled Trial. Phys Ther. 2023;103(11).
Criner GJ, Gayen S, Zantah M, Dominguez Castillo E, Naranjo M, Lashari B, et al. Clinical review of non-invasive ventilation. Eur Respir J. 2024;64(5).
Eberle C, Stichling S. Clinical Improvements by Telemedicine Interventions Managing Type 1 and Type 2 Diabetes: Systematic Meta-review. J Med Internet Res. 2021;23(2):e23244.
De Rezende DRB, Neto IA, Iunes D, Carvalho LC. Analysis of the effectiveness of remote intervention of patients affected by chronic diseases: A systematic review and meta-analysis. The Journal of Medicine Access. 2023;7.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Syeda Ranna Fatima, Zoha Alamgir, Hafiza Samin Anjum, Akif Saeed Ch, Muhammad Taif, Ramsha Azmatullah (Author)

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.