eHealth Use and Disease Control During COVID-19 among Diabetes Patients in China and the Philippines

Background: According to the WHO 2020 NCD report, the COVID-19 pandemic disrupted diabetes care in 49% of countries. eHealth emerged as a solution to disease management challenges during the unprecedented outbreak. Due to the rapidly expanding nature of eHealth use during the pandemic, this study aimed to determine 1) the sociodemographic factors associated with eHealth during COVID-19 and 2) whether eHealth was associated with diabetes management and clinical outcomes. Methods: Using quantitative data from cross-sectional surveys from Kunshan and Taicang, China (n=309) and Manila, Philippines (n=150) (data sets uncombined), we performed Chi-squared and Fisher’s exact tests and univariate logistic regressions to determine the relationship of eHealth use and sociodemographic characteristics. We then performed logistic and linear regression to determine the association of eHealth use with diabetes disease outcomes. Results: In China, younger age (p=0.02), higher education level (p=0.001), married marital status (p=0.03), suburban residence type (p=0.001), and higher household monthly income during COVID-19 (p=0.004) were associated with using eHealth. In the Philippines, younger age (p= 0.009) and higher education level (p=0.01) were associated with eHealth use. eHealth use was associated with undergoing FBS testing in the last three months (OR = 2.19, 95%CI = 1.00, 4.78), undergoing HbA1c testing in the last three months (OR = 3.64, 95%CI = 1.01, 13.15), and reporting disease control per their last HbA1c test (OR = 9.98, 95%CI = 3.41, 29.18) in the Philippines, adjusting for various demographic characteristics. Conclusions: Our data indicated eHealth use could positively affect diabetes clinical and management outcomes for people with diabetes in China and the Philippines. We posit more research is needed for the impacts of eHealth on clinical outcomes as well as the methods for eHealth implementation and integration in LMIC.