Abstract
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Abstract
Year 2021
October 2021

SHBC1359

Abstract Title
Clinical Impact of Video Consultation in Primary Care
Authors

K.J.LEW1, W.L.D.NG1, S.S.J.TING1, J.W.KONG1, K.W.TAN1, Z.LIM1, W.S.C.CHONG1, C.S.E.SIM1, E.S.LEE1, K.W.S.WONG1

Institutions

NHG Polyclinics1

Background & Hypothesis

Video-consultations (VC) were implemented for the care of chronic conditions in National Healthcare Group polyclinics during the Covid-19 pandemic. We evaluated the clinical effectiveness of VC in comparison to usual face-to-face (FTF) consultations for chronic disease management.

Methods

Observational data was obtained from the medical records database for eligible patients who had a VC for diabetes, hypertension or hyperlipidaemia. We conducted 1:2 propensity score matching to identify a FTF comparison group using demographic and disease-related variables. Linear mixed models were used to conduct a difference-in-differences analysis (DiD) for HbA1c, blood pressure and LDL-cholesterol outcomes at 6 months, for patients with and without diabetes. Data analysis was conducted using the R statistical package.

Results

We compared 922 VC consults with 1844 FTF consults. HbA1c levels of VC patients with diabetes six months after consultation was non-inferior to that of FTF consultations (DiD:-0.058%; 95%CI:-0.167%,0.052%, using a non-inferiority margin of 0.4%). VC patients had a greater reduction in blood pressure over six months for patients without diabetes (DiD:-1.91 mmHg; 95%CI:-3.53,-0.30) though it was not statistically significant for those with diabetes (DiD:-1.01 mmHg; 95%CI:-3.03,1.01). Low-density lipoprotein (LDL) cholesterol levels was not significantly different between VC and FTF consultations for both patients with diabetes (DiD:0.010 mmol/L; 95%CI:-0.139,0.159) and without diabetes (DiD:0.111 mmol/L; 95%CI:-0.026,0.247).

Discussion & Conclusion

VC for patients with diabetes, hypertension or hyperlipidaemia was comparable to FTF over a six-month period indicating its clinical effectiveness and safety over the short term. Future longitudinal evaluation needs to be conducted to assess the differences for clinical effectiveness over the long term.

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