Virtual Care Coordination for Patients Attending Diabetic Clinics in Selected Hospitals in Nairobi City County, Kenya: A Systematic Review

Background Diabetes mellitus (DM) remains a global public health challenge, with low- and middle-income countries (LMICs) disproportionately affected by the rising incidence. Virtual care coordination (VCC), incorporating telemedicine, mobile health (mHealth) applications, and electronic health records (EHRs), is being increasingly recognized as a promising approach to improving diabetes management. However, while VCC has been widely studied in high-income countries, its effectiveness and scalability in LMICs, particularly Nairobi City County, Kenya, are not well-documented. Objective This systematic review aims to synthesize existing literature on the outcomes of VCC for diabetes management in LMICs, focusing on identifying what is known and what is not, including critical gaps in the literature. Methods A systematic literature review was conducted by searching three primary databases: PubMed, Scopus, and Google Scholar. The search utilized the following terms: “virtual care,†“telemedicine,†“diabetes management,†“low-resource settings,†and “care coordination.†Only studies published between 2018 and 2023 were included to ensure the relevance and currency of the information. The focus on recent publications allows for including the latest advancements, technologies, and care models, ensuring that the review captures the most current evidence available on the effectiveness of virtual care coordination (VCC) in diabetes management. Studies were excluded if they focused on non-diabetes-related interventions or were conducted in high-income countries, as the aim was to assess VCC interventions specifically within resource-constrained settings. Additionally, conference abstracts, unpublished studies, or articles not available in English were excluded to maintain consistency and accessibility of the included studies. The systematic approach aimed to narrow the focus to the most relevant and recent studies that address the research objectives effectively. Results Twenty-seven studies met the inclusion criteria. VCC significantly improved glycaemic control, with reductions in HbA1c ranging from 0.5% to 2%. Hospital readmissions decreased by 15%–25%, and patient satisfaction scores ranged from 70% to 90%. However, barriers such as limited digital literacy, infrastructural challenges, and cultural resistance hindered its implementation. Few studies addressed long-term sustainability, cost-effectiveness, or equity issues. Conclusion VCC demonstrates strong potential to improve diabetes outcomes in resource-constrained settings. To scale VCC effectively, policymakers must address digital infrastructure gaps, provide digital literacy training, and develop culturally tailored solutions. Future research should explore cost-effectiveness, long-term impacts, and strategies to ensure equitable access to VCC interventions in LMICs.