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Session: Innovations in Infant, Pediatric, and Pregnancy Nutrition Research: New Tools and Methodologies (Poster Theater Flash Session 1)

(PTFS01-07-23) Perspectives and Perceived Usability of Telemonitoring Services Among Pregnant Women With Gestational Diabetes in Dhulikhel, Nepal

Saturday, July 22, 2023

10:25 AM – 10:29 AM ET

Location: Fairfax

Presenting Author(s)

Shristi Rawal, PhD (she/her/hers)

Assistant Professor
Rutgers University
Philadelphia, Pennsylvania, United States

Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

Co-Author(s)

KC

Kalpana Chaudhary, Master's in public health

Department of Public Health, Kathmandu University School of Medical Sciences, Institute for Implementation Science and Health, Nepal
JN

Jyoti Nepal, Masters in Public Health

Department of Research and Development, Dhulikhel Hospital-Kathmandu University Hospital, Nepal
SS

Smriti Shrestha

Department of Community Programs, Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Nepal
SB

Sangam Banjara

Department of Community Programs, Dhulikhel Hospital, Kathmandu University Hospital, Nepal
AS

Abha Shrestha

Department of Obstetrics and Gynecology, Dhulikhel Hospital, Kathmandu University Hospital, Nepal
PS

Prabin R. Shakya, MS

Biomedical Knowledge Engineering Lab, Seoul National University
Seoul, Seoul-t'ukpyolsi, Republic of Korea
AS

Archana Shrestha, PhD

Associate Professor
Department of Public Health, Kathmandu University School of Medical Sciences, Nepal, Institute for Implementation Science and Health, Nepal, Department of Chronic Disease Epidemiology, Yale School of Public Health
Dhulikhel, Bagmati, Nepal

Disclosure(s):

Shristi Rawal, PhD: No relevant financial relationship(s) with ineligible companies to disclose.

Objectives: Evidence from high-income countries supports that telemonitoring can improve patient satisfaction, reduce costs, and achieve better or similar pregnancy outcomes among patients with gestational diabetes mellitus (GDM), but data are lacking from low-income countries like Nepal. Here, we assessed the usability and acceptability of telemonitoring services for management of GDM among Nepalese women.

Methods: We conducted a convergent parallel mixed method study among 50 pregnant women diagnosed with GDM in Dhulikhel Hospital, Nepal. Participants were provided a glucometer and a blood pressure monitor, along with instructions to measure and record their blood pressure and glucose levels at least once a week. The study nurse reviewed measurements obtained at home during the biweekly telemonitoring follow-up from 28 weeks of gestation alternating with their hospital visit. System Usability Scale (SUS) was used to assess the perceived usability of the telemonitoring services. Eight participants underwent in-depth interviews, which were focused on learning about patients' experiences with telemonitoring and related technology, including feasibility, utility, acceptability, satisfaction with care, usability, as well as any challenges or unmet needs. We transcribed interviews verbatim and framework analysis was done using Dedoose software.

Results: The mean SUS score for telemonitoring service was 70.3±8.5 score, indicating good usability score (score ≥68 indicates good usability). About 82% of the participants agreed that they would like to use this service frequently. The primary challenge related to telemonitoring services were time constraints, particularly among working women. Perceived benefits were frequent health monitoring, two-way communication between service provider and the patient, and reminders for follow-up. All participants expressed their satisfaction with the features and quality of the tele-monitoring services for GDM management. They believed that telemonitoring service was useful in facilitating continuity of prenatal care.

Conclusions: Telemonitoring is a feasible and acceptable tool to facilitate close monitoring of pregnant women with GDM in our peri-urban hospital setting in Nepal.

Funding Sources: NIH/FIC