Teleconsultation for pediatric patients with type 1 diabetes mellitus during the COVID-19 pandemic: experience of a university hospital in Brazil

Santana, Yasmin Eugênia; Liberatore, Raphael Del Roio

doi:10.1016/j.jped.2022.02.001

Cited by 3 publications

(3 citation statements)

References 5 publications

(4 reference statements)

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“…However, a study 100 (n=143) that used telephone calls and text messages to send blood glucose values, check insulin doses, and periodically monitor for acute complications in patients with type 1 diabetes observed worsening of HbA1c in 46% of patients. A Brazilian center 101 (n=747) assessed a telemedicine program without specific training and found hospitalization rates increased by ∼50%.…”

Section: Resultsmentioning

confidence: 99%

Disruption to diabetes and hypertension care during the COVID-19 pandemic in Latin America and the Caribbean and mitigation approaches: A Scoping Review

Ogungbe,

Jabakhanji,

Mehta

et al. 2024

Preprint

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Summary Background The COVID-19 pandemic disrupted care for non-communicable diseases globally. This study synthesizes evidence on disruptions to primary care, focusing on hypertension and diabetes care and mitigation approaches taken during the pandemic in Latin America and the Caribbean (LAC). Methods We conducted a scoping review, searching nine electronic databases for studies from January 2020 to December 2022 on COVID-19-related primary care disruptions and interventions, including studies on hospital-based interventions given their relevance to the pandemic response in LAC. We adapted the Primary Health Care Performance Initiative framework to develop our search strategy and synthesize data. For studies reporting interventions, we included studies conducted outside of LAC. Findings Of 33,510 references screened, 388 studies were included (259 reported disruptions in LAC, 61 interventions in LAC, 63 interventions outside LAC, and five interventions from countries within and outside LAC), with three-quarters presenting data from Brazil, Argentina, Mexico, and Peru; few studies focused on rural areas. Additionally, the few studies that adequately quantified care disruptions reported a reduction in hypertension and diabetes control during the pandemic (e.g., hypertension control rate decreased from 68% to 55% in Mexico). Frequently reported causes of disruption included burnout and mental health challenges among healthcare workers (with disproportionate effects by type of worker), reduced medication supplies, and reduced frequency of clinic visits by patients (e.g., due to financial constraints). The most reported interventions included remote care strategies (e.g., smartphone applications, virtual meeting platforms) and mental health programs for healthcare workers. Remote care strategies were deemed feasible for care delivery, triaging, and clinical support for non-physicians. Patients were generally satisfied with telemedicine, whereas providers had mixed perceptions. Robust evidence on the effectiveness of remote care strategies for diabetes and hypertension care was unavailable in LAC. Interpretation Hypertension and diabetes control appeared to worsen in LAC during the pandemic. Major reported causes of care disruptions were workforce issues, reduced medication supply, and changes in patient perceptions of seeking and receiving primary healthcare. Remote care strategies were feasible for various purposes and were well received by patients. However, the lack of data on intervention effectiveness underscores the importance of strengthening research capacity to generate robust evidence during future pandemics. Developing resilient healthcare systems able to provide care for hypertension and diabetes during future pandemics will depend on investment in the healthcare workforce, medical supply chain, health data and research infrastructure, and technology readiness.

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Section: Resultsmentioning

confidence: 99%

Disruption to diabetes and hypertension care during the COVID-19 pandemic in Latin America and the Caribbean and mitigation approaches: A Scoping Review

Ogungbe,

Jabakhanji,

Mehta

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…After 3 and 6 months of remote visits, Time in Range and Time Above Range significantly improved just as their psychological health ( 19 ). However, in low-middle income countries and in rural areas telemedicine services where used, have proved useful in maintaining regular patient follow-up but not always effective in maintaining a good glycemic control ( 17 , 18 ). The role of telehealth, in these areas where technology is less used, may be fundamental to decrease clinical costs through the prompt diagnosis of decompensation, fewer visits to the emergency room for complications like ketoacidosis and severe hypoglycemia, and healthier lifestyle behaviors ( 26 ).…”

Section: Discussionmentioning

confidence: 99%

“…Telemedicine proved to be effective and not inferior to face-to-face visits in maintaining or improving glycemic control in pediatric patients affected by T1D ( 13–16 ). Despite the barriers encountered in implementing this service, telemedicine is essential as an alternative follow-up tool for a chronic disease such as diabetes ( 17–21 ). Many healthcare professionals of the diabetes teams have been satisfied with the use of telemedicine in patients with T1D and consider it a clinical practice to be strengthened in the future ( 22 ).…”

Section: Introductionmentioning

confidence: 99%

Advanced Hybrid Closed Loop users’ satisfaction of telemedicine and telenursing in pediatric and young adult type 1 diabetes

Bassi,

Dufour,

Strati

et al. 2023

Front. Public Health

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Background and aimsThe aim of the study was to evaluate the satisfaction of the use of telemedicine and telenursing in children and young adults with Type 1 Diabetes (T1D) using Advanced Hybrid Closed Loop systems (AHCL) with a focus on the role of connectivity, data download and the ease of technical steps in the set and sensor change procedures.MethodsAn online anonymous survey was administered to AHCL users. The questionnaire consisted of five Clusters: Cluster A-B-C included questions related to the general satisfaction in the use of telemedicine, Cluster D was focused on the role of data download and connectivity, Cluster E was related to satisfaction in telenursing and Cluster F to the perception of ease of execution of the technical steps like changing the infusion set and the sensor.ResultsWe collected 136 completed questionnaires. 83.8% of AHCL users were overall satisfied with the quality of the telemedicine service. 88.2% of patients downloaded AHCL data before visits and the overall quality of televisits (data sharing, connectivity, ease of use) was satisfactory for 85.3% of users. Telenursing support during set and sensor change procedures was considered effective by 98% of AHCL users. The sensor and insulin infusion set change procedure is perceived as different for the two systems: set change simpler for Medtronic (p = 0.011) users, while sensor change was simpler for Tandem users (p = 0.009).ConclusionTelemedicine and telenursing have an essential role in diabetology and are highly appreciated in AHCL users. The nurse support in the education of the use of AHCL systems is effective and must be implemented. Unfortunately, not all patients have the technological tools needed for downloading data at home and using telemedicine services; this represents an important challenge for the future of diabetology and for the equity in accessibility to care.

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The impact of the COVID-19 pandemic and associated disruptions in health-care provision on clinical outcomes in people with diabetes: a systematic review

Hartmann-Boyce,

Highton,

Rees

et al. 2024

The Lancet Diabetes & Endocrinology

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Teleconsultation for pediatric patients with type 1 diabetes mellitus during the COVID-19 pandemic: experience of a university hospital in Brazil

Cited by 3 publications

References 5 publications

Disruption to diabetes and hypertension care during the COVID-19 pandemic in Latin America and the Caribbean and mitigation approaches: A Scoping Review

Disruption to diabetes and hypertension care during the COVID-19 pandemic in Latin America and the Caribbean and mitigation approaches: A Scoping Review

Advanced Hybrid Closed Loop users’ satisfaction of telemedicine and telenursing in pediatric and young adult type 1 diabetes

The impact of the COVID-19 pandemic and associated disruptions in health-care provision on clinical outcomes in people with diabetes: a systematic review

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