Role of Digital Health Technologies in Improving Chronic Disease Management: An Interdisciplinary Study of Clinical Care, Patient Behaviour and Healthcare Accessibility

Abstract

Background: Chronic diseases require continuous monitoring, adherence and regular clinical contact, which many patients, particularly rural patients, struggle to obtain.
Objective: This study examined how digital health technologies (DHTs) relate to clinical outcomes, patient behaviour and healthcare accessibility among adults with type 2 diabetes mellitus and/or hypertension.
Methods: A hospital-based analytical cross-sectional study was conducted among 420 adults using a structured questionnaire (eHealth Literacy Scale, perceived usefulness, perceived accessibility and Medication Adherence Report Scale) linked to clinical records of glycated haemoglobin (HbA1c) and blood pressure. Analyses included chi-square tests, Welch t-tests, ANOVA, correlation, linear and logistic regression and bootstrapped mediation.
Results: Overall, 60.5% of participants used at least one DHT. Use was lower among rural (45.6%) than urban (71.7%) patients, declined with age and rose with education and income (all p < 0.01). Users reported higher digital health literacy, perceived accessibility and medication adherence (Cohen’s d 0.72–0.97) and had lower HbA1c (7.79% vs 8.27%, p < 0.001); the difference in systolic blood pressure was not significant (p = 0.081). High-intensity use independently predicted adherence (β = 0.26, p < 0.001). Adherence mediated 55% of the association between DHT use and HbA1c (indirect effect −0.288; 95% CI −0.430 to −0.164).
Conclusions: DHTs appear to improve chronic disease control mainly through patient adherence and access, but benefits are unevenly distributed across the digital divide. [Simulated values — replace.]