Abstract
Objective: The aim of this study is to analyse the impact of a digital self-care intervention during the Covid-19 pandemic on the control of hypertension and diabetes in low-income populations comorbid with these conditions. Design and method: This was a retrospective study of 665 people in Nigeria (213 male, 431 female. Mean age - 58 years) with comorbid diabetes and hypertension enrolled on mDoc's digital self-care CompleteHealth™ platform from March 2020 till November 2021. Through the virtual platform, they were able to track their blood pressure and fasting blood glucose levels as well as co-create action plans with goals suited to achieve the best health outcomes with a virtual health coach. They were given personalised guidance and health education to help control their conditions. The change in blood pressure and fasting blood glucose level was calculated as the difference between the baseline value of the metric (the first value entered on CompleteHealth™) and the average of subsequent values entered on the platform. Results: 600 people (90.2%) had at least 1 interaction with a virtual health coach for a total of 10,030 interactions with the coach-led multidisciplinary team. Of the 665 people included in the study, 407 (61,2%) entered a subsequent blood pressure value, with systolic and diastolic blood pressure declining by an average of 6.25 mmHg and 4.27 mmHg respectively. 68.3% of these people had controlled blood pressure at the end-line, up from 41.8% at the baseline. 50.6% of these people saw an improvement in both systolic and diastolic blood pressure of 19.52 mmHg and 12.63 mmHg respectively. Of the 266 people (40%) who entered multiple blood glucose levels, 31.95% had controlled blood glucose levels with an average decline of 15.5 mmol/L. 58.65% saw an improvement in their blood pressure value of 44.44 mmol/L. Conclusions: Our findings suggest that digital self-care can play a key role in supporting low-income populations living with diabetes and hypertension during the COVID-19 pandemic where restrictions exist on in-person service provision.
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