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Randomized Controlled Trial
. 2022 Nov;16(6):1419-1427.
doi: 10.1177/19322968211035768. Epub 2021 Jul 30.

Virtual Group Appointments Reduce Distress and Improve Care Management in Young Adults with Type 1 Diabetes

Daniel I Bisno  1 , Mark W Reid  1 , Jennifer L Fogel  1 , Elizabeth A Pyatak  2 , Shideh Majidi  3 , Jennifer K Raymond  1   3   4
Affiliations
Randomized Controlled Trial

Virtual Group Appointments Reduce Distress and Improve Care Management in Young Adults with Type 1 Diabetes

Daniel I Bisno et al. J Diabetes Sci Technol. 2022 Nov.

Abstract

Purpose: The purpose of this study was to analyze the impact of virtual group appointments (VGA) on self-reported health-related outcomes and care activities for young adults (YA) with type 1 diabetes (T1D).

Methods: Fifty-three YA (ages 18-25 years) with T1D participated in a randomized controlled trial (RCT) of the Colorado Young Adults with T1D (CoYoT1) Clinic intervention, encompassing telehealth (TH) with or without VGA. Both new patients (n = 32) and those who participated in a pilot phase (n = 26) were randomized to CoYoT1 Clinic (TH+VGA; n = 23) or TH-only (n = 35) and followed for 1 year. YA completed the Diabetes Distress Scale (DDS), Diabetes Strengths and Resilience (D-STAR), Self-Efficacy in Diabetes (SED), Self-Management of Type 1 Diabetes in Adolescence (SMOD-A), Center for Epidemiologic Studies Depression (CES-D), and EuroQol (EQ-5D) scales at baseline and study end.

Results: YA were 67% female, 84% white, 10% Latinx, and the mean age was 20.4 years old. At study end, participants in CoYoT1 Clinic reported significantly reduced diabetes distress compared to those in TH-only, who reported increased levels [Effect Size (ES) = -0.40, P = .02]. Specifically, CoYoT1 Clinic participants reported relative reductions in Physician (ES = -2.87, P = .02) and Regimen-related distress (ES = -0.35, P = .01). In addition, participants in CoYoT1 Clinic reported improved self-management of T1D-related problem solving (ES = 0.47, P = .051) and communication with care providers (ES = 0.39, P = .07).

Conclusions: Virtual group attendance in CoYoT1 Clinic was associated with significant improvements in diabetes-related distress. Long-term exposure to VGA should be investigated in YA with T1D and other pediatric chronic conditions.

Keywords: group appointments; shared medical appointments; telehealth; type 1 diabetes; virtual care; young adults.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Schema of the study analysis.
Figure 2.
Figure 2.
Changes in diabetes distress (DDS) over study year.
Figure 3.
Figure 3.
Changes in self-management of T1D Care (SMOD-A) over study year.
See this image and copyright information in PMC

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