Type 2 diabetes mellitus (T2DM) requires long-term self-management; however, maintaining adherence and continuity of care remains challenging in many primary healthcare settings. Previous phases of this intervention at Lien Chieu District Medical Center, Da Nang city demonstrated improvements in clinical parameters, including HbA1c and fasting glucose, compared with standard care. Building on those clinical findings, the present analysis focuses on patient-centered and implementation outcomes. This study aimed to assess medication adherence, health-related quality of life (HRQoL), and the perceived acceptability, feasibility, and appropriateness of the telehealth model to inform its potential for broader application

A mixed-methods design was employed. The quantitative component involved a quasi-experimental study of 230 outpatients with T2DM, allocated equally to intervention and control groups. Medication adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8), and HRQoL using the SF-36. Outcomes were compared at baseline and at 6 months using chi-square tests and generalized estimating equations (GEE). The qualitative component included in-depth interviews with patients (n=11) and healthcare professionals (n=9), and two focus group discussions. A thematic analysis was conducted to explore perceptions of acceptability, feasibility, and appropriateness.

At 6 months, the proportion of patients classified as adherent was significantly higher in the intervention group (90.7%) compared with the control group (56.5%) (p=0.024). In adjusted GEE models, patients receiving telehealth support had higher odds of achieving adherence (OR=2.706; 95% CI: 1.621-4.517). HRQoL also improved in the intervention group, with the proportion reporting good HRQoL rising from 36.5% at baseline to 56.5% at 6 months, whereas the control group remained lower (39.8%) (p=0.014). Qualitative findings indicated generally positive perceptions, particularly regarding convenience and continuity of support. Participants noted that the model could be integrated into existing workflows, although challenges related to digital literacy and resource availability were identified.

Telehealth-supported primary care was associated with improved adherence, HRQoL, and implementation outcomes among patients with T2DM in this setting. While further evaluation in diverse populations is warranted, these findings suggest that telehealth may effectively complement the routine management of chronic diseases in resource-constrained primary healthcare systems.