Abstract
This study evaluated the effectiveness and implementation of a telecare-enhanced hybrid consultation model for diabetes management in public general outpatient clinics. In a single-blind, non-inferiority randomized controlled trial involving 786 adults with type 2 diabetes across seven clinics, participants were assigned to either a hybrid care group, receiving alternating telecare and in-person consultations, or a control group, receiving in-person care only, over 84 weeks. The intervention group (IG) showed comparable HbA1c levels to the control group (CG). Blood pressure readings were consistently lower in the IG, and medication adherence remained stable, unlike the CG, which experienced a midline decline. All clinics sustained the telecare model post-trial. Implementation was facilitated by strong leadership and a reliable digital infrastructure, though challenges such as digital literacy and staff workload remained. The model proved effective, comparable cost, and feasible within a public healthcare setting.
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All proposals for data use will need the approval of the study team before any data are released. Usage rights for the raw data are retained by the study team. De-identified individual participant data will be available upon reasonable request to researchers. Requests should be directed to the corresponding author via email, accompanied by a detailed research proposal. Access will be granted following the approval of the proposal and the signing of a data access agreement. Only data from participants who have consented to share their data will be provided. Data sharing will be authorized following proposal approval and the execution of a signed data access agreement, strictly for scientific use.
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Acknowledgements
This study was funded by the Health and Medical Research Fund, Health Bureau, Hong Kong (Ref: 18191221). We extend our heartfelt thanks to the Hong Kong Hospital Authority and the seven GOPCs within the New Territories West Cluster for their organization and support, which provided the foundation for the design and implementation of our eRAMP services. We are deeply grateful to the multidisciplinary team, including doctors, nurses, optometrists, dietitians, podiatrists, physiotherapists, and patient care assistants, whose continuous cooperation, support, and collaboration were essential for the successful implementation and validation of our hybrid model. We sincerely thank all of the patients who participated in this study; their trust, acceptance, participation, and feedback were crucial to achieving our research objectives. Additionally, we express our appreciation to the HA Go technical team for their essential technical support and continuous optimization of our telecare model.
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A.W. and F.W. developed the conception and design of the initial study. A.W. was responsible for obtaining funding. A.W., S.C., and L.L. performed the statistical analyses, interpreted the data, and drafted the manuscript. J.L., D.T., M.C., M.W., B.W., V.H., C.T., W.H., and S.C. provided a critical review of the manuscript and intellectual input on the study design, methodology, and evaluation. All authors contributed to, reviewed, and approved the manuscript. All authors were responsible for the decision to submit for publication.
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Wong, A.K.C., Chen, SC., Wong, F.K.Y. et al. Evaluating eRAMP telecare for diabetes in outpatient clinics: a hybrid effectiveness-implementation study. npj Digit. Med. (2026). https://doi.org/10.1038/s41746-026-02424-9
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DOI: https://doi.org/10.1038/s41746-026-02424-9
