Non-adherence to polypharmacy is possibly most common reason for poor outcomes among T2D patients on treatment. We evaluated role of telemedicine(TM group) based follow up ensuring drug compliance & better health outcomes compared to conventional treatment setting with occasional group education. Diabetes Tele Management System (DTMS®) involves unique software & trained multidisciplinary diabetes team communicating via phone/email for slow, steady titration of drugs & tele-counselling.

Self-reported compliance questionnaire & semi-structured interview were conducted in T2D enrolled in DTMS & in general diabetes camps by Diabscreen Kerala (DK group) from Aug 2011-July 12. Respondents (83%) included 2439 patients in TM of >2 follow up/ month with DTMS® & 1985 patients in DK (Fig.1). On analysis, only 12.7% in DK were on insulin despite being suggested vs 72.4% in TM. DK group stopped all drugs(12.7% vs 0.6%), BP drugs (47.6% vs 2.6%) & statins (74.8% vs 1%) more frequently than TM group due to various misconceptions. Drug compliance in TM is ensured via DTMS® by way of customized brief education modules, mitigating misconceptions about side effects of drugs with specific reference to continuation of statins, BP, anti-diabetes medications & verifying purchase from hospital pharmacy. DTMS® ensured statistically significant drug compliance (93%) vs conventional treatment setting (59.7%) underscoring utility of telemedicine as a cost effective patient education tool.