Study: Pediatric type 1 diabetes families prefer virtual care and telehealth 

Study: Pediatric type 1 diabetes families prefer virtual care and telehealth | Image Credit: © Studio Romantic - © Studio Romantic - stock.adobe.com.

An increased desire for telehealth and virtual care was observed in a study published in the Canadian Journal of Diabetes highlighting pediatric diabetes care amid the COIVD-19 pandemic.

During the pandemic, increased exposure to telehealth and virtual care was seen in multiple areas in health care, including for pediatric type 1 diabetes (T1D). At the onset of the pandemic, the diabetes team at British Columbia Children’s Hospital (BCCH) shifted away from in-person routine diabetes visits, to completely virtual, by video or telephone. Though this type of transition was observed in various parts of the world during the pandemic’s onset, little evidence was available to gauge the effectiveness and quality of these services for pediatric T1D.

Investigators sought to determine changes in telehealth usability and future preference changes for telehealth care. According to the study authors, telehealth has been shown to have a positive impact on adherence, glucose management, and the financial impact for families. The multidisciplinary diabetes team at BCCH, the sole tertiary children’s hospital in British Columbia, serves approximately 900 children with diabetes across British Columbia.

To determine potential change in usability and future preference of telehealth care, the investigators used data from the Telehealth Usability Questionnaires (TUQ), which were administered at BCCH during the first 3 months of the pandemic, and more than 1 year later. Patient families were contacted by BCCH administrative staff to conduct the telehealth visits, and were offered telephone or virtual options, with each scheduled visit set for 30 minutes. Prior to each telehealth visit, the family was contacted by a diabetes nurse educator, who encouraged the family to submit blood glucose and insulin dose information via email, including any pump and/or continuous glucose monitoring (CGM) data. All families that had a telehealth visit scheduled in the “early pandemic period” (March 25 to May 27, 2020) were invited to participate in the survey. More than 1 year later, families that had telehealth visits between May 1 and November 6, 2023 (“later pandemic period”), were invited to take the TUQ. The pediatric patient, or a parent/caregiver both completed the surveys. Families with visits scheduled in both study periods were offered the chance to take both surveys.

The overall response rate was 40%, according to study results. In the initial study, which featured 87 participants, 72% of families said they hoped to continue telehealth after the pandemic. Twenty-four percent of families said they would prefer all future care to be in person.

Over time, virtual visits (audio and video) improved in “ease of use” (mean difference: 0.39 [.017-.061] [95% confidence interval]) and “satisfaction” (mean difference: 0.28 [0.01-0.55] [95% confidence interval]). Of 168 participants in the “later pandemic period” survey group, narrative comments about what was “most helpful” and what participants “didn’t like” were recorded. Overall, there were 129 “most helpful” responses and 127 “didn’t like responses.”

When examining adjust associations between use preference regarding future telehealth visits, “the odds of indicating higher preference for more future virtual visits in the later pandemic group was 5.1-fold higher than that in the early pandemic group,” the authors noted (odds ratio, 5.10; 95% confidence interval, 1.02-21.70 [P = 0.0298]). Eighty percent of survey participants said they would prefer their future care to include telehealth in place of some or all in-person visits after the pandemic, with the most-wanted future combinations of care being 2 in-person and 2 telehealth visits (28%).

In a rapidly changing landscape of pediatric diabetes care, authors highlighted that desire for future telehealth care has increased. Results of this study can be used to plan future care delivery at the study center. The authors noted that continued examination of telehealth is key in optimizing and delivering patient-centered care.

Reference:

Niyyati S, Fung A, Zhang Q, et al. Patient perceptions of telehealth for pediatric type 1 diabetes during the COVID-19 pandemic: a follow-up study. Can J Diabetes. 2023 May 13:S1499-2671(23)00126-0. doi: 10.1016/j.jcjd.2023.05.005. Epub ahead of print. PMID: 37187438; PMCID: PMC10182595.