Implementation science perspectives on implementing telemedicine interventions for hypertension or diabetes management: scoping review
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Abstract
BACKGROUND: Hypertension and diabetes are becoming increasingly prevalent worldwide. Telemedicine is an accessible and cost-effective means of supporting hypertension and diabetes management, especially as the COVID-19 pandemic has accelerated the adoption of technological solutions for care. However, to date, no review has examined the contextual factors that influence the implementation of telemedicine interventions for hypertension or diabetes worldwide. OBJECTIVE: We adopted a comprehensive implementation research perspective to synthesize the barriers to and facilitators of implementing telemedicine interventions for the management of hypertension, diabetes, or both. METHODS: We performed a scoping review involving searches in Ovid MEDLINE, Embase, CINAHL, Cochrane Library, Web of Science, and Google Scholar to identify studies published in English from 2017 to 2022 describing barriers and facilitators related to the implementation of telemedicine interventions for hypertension and diabetes management. The coding and synthesis of barriers and facilitators were guided by the Consolidated Framework for Implementation Research. RESULTS: Of the 17,687 records identified, 35 (0.2%) studies were included in our scoping review. We found that facilitators of and barriers to implementation were dispersed across the constructs of the Consolidated Framework for Implementation Research. Barriers related to cost, patient needs and resources (eg, lack of consideration of language needs, culture, and rural residency), and personal attributes of patients (eg, demographics and priorities) were the most common. Facilitators related to the design and packaging of the intervention (eg, user-friendliness), patient needs and resources (eg, personalized information that leveraged existing strengths), implementation climate (eg, intervention embedded into existing infrastructure), knowledge of and beliefs about the intervention (eg, convenience of telemedicine), and other personal attributes (eg, technical literacy) were the most common. CONCLUSIONS: Our findings suggest that the successful implementation of telemedicine interventions for hypertension and diabetes requires comprehensive efforts at the planning, execution, engagement, and reflection and evaluation stages of intervention implementation to address challenges at the individual, interpersonal, organizational, and environmental levels.
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Compared with the scoping review by Khalid et al. on telemedicine for hypertension/diabetes, this study overlaps highly with the individual characteristics and outer setting domains (technology literacy gaps, cultural/language barriers, rural accessibility issues).
“Compared with the scoping review by Khalid et al. on the implementation of telemedicine for hypertension/diabetes (123), this study overlaps highly with the individual characteristics and outer setting domains (technology literacy gaps, cultural/language barriers, rural accessibility issues).”
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“Compared with the scoping review by Khalid et al. on the implementation of telemedicine for hypertension/ diabetes (123), this study overlaps highly with the individual characteristics and outer setting domains (technology literacy gaps, cultural/language barriers, rural accessibility issues).”
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Telemedicine for hypertension: opportunities and responsibilities in management
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Digital Solutions for Chronic Disease Management in Primary Care Settings
Christopherson, K. A., Kobeissi, M. M., & Hong, Y.-F. (2026) · The Journal for Nurse Practitioners · doi:10.1016/j.nurpra.2026.105779
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Arya, N. G., Koltchine, V., Gearinger, T., Buehler, S., Nooraie, R. Y., & Ramchandran, R. S. (2026) · doi:10.2196/preprints.106290
Arya, N. G., Koltchine, V., Gearinger, T., Buehler, S., Nooraie, R. Y., & Ramchandran, R. S. (2026) · JMIR Diabetes · doi:10.2196/106290
- Authors
- Khalid, A., Dong, Q., Chuluunbaatar, E., Haldane, V., Durrani, H., & Wei, X.
- Affiliations
- University of Toronto (CA)
- Corresponding author
- Wei, Xiaolin
- ORCID
- Venue
- Journal of Medical Internet Research
- Publisher
- JMIR Publications Inc.
- Published
- 2023-03-14
- Volume
- 25
- Pages
- e42134
- ISSN
- 1438-8871 (ISSN-L)
- PMC
- PMC10131907
- OpenAlex
- W4318443094
- Cited by
- 27
- References
- 77
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 10 · 2023: 1
- FWCI
- 1.33
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Journal of Medical Internet Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- University of Toronto
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- telemedicine, antihypertensive therapy, diabetes management, implementation barriers, implementation facilitators, Consolidated Framework for Implementation Research, technological literacy, implementation climate, language and cultural barriers, rural patients, COVID-19 pandemic
- MeSH terms
- Implementation Science, Diabetes Mellitus, Health Services Accessibility, Humans, Hypertension, Patient Care Management, Telemedicine
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