Exploring the impact of digital care delivery for patients with diabetes and hypertension: A longitudinal qualitative study

Background Diabetes and hypertension disproportionately affect socioeconomically disadvantaged populations. Telehealth programs offer opportunities to improve access, engagement, and outcomes, yet little is known about patients’ experiences or their impact on patient-reported outcomes. This study focuses on the OnCall Advanced Care (OCAC) program, a high-touch telehealth model that combines remote monitoring, nurse-led support, and 24/7 access to clinical staff. Aim To identify the patient-reported outcomes of the OCAC program and assess whether participation improves patients’ perceptions of diabetes and hypertension management over time. Design Longitudinal, qualitative research design using semi-structured interviews. Methods Patients diagnosed with diabetes and/or hypertension and enrolled in the program were recruited via text, letter, and/or phone. Three semi-structured interviews were conducted at around the time of enrollment, 3–4 months, and 6–9 months post-enrollment. Interviews lasted 30–70 minutes and were thematically analyzed. Results Thirty-eight patients completed the first interview, 29 the second, and 18 the third. Five major themes emerged: behavioral changes, access to care, health-related quality of life, knowledge of condition, and changes in symptoms and overall health . Participants also reported improved self-management, increased medication adherence, and improved eating habits, as well as a reduced reliance on emergency departments and greater access to primary and specialty care. Over time, patients reported improved blood pressure and blood glucose control, weight loss, and increased confidence in managing their disease. Conclusion Telehealth programs can have a positive influence on patient behavior change and health outcomes. This highlights the importance of further investigating telehealth implementation and patient-reported outcomes.