Importance of Patient–Provider Communication to Adherence in Adolescents with Type 1 Diabetes

Patel, Niral; Datye, Karishma A.; Jaser, Sarah S.

doi:10.3390/healthcare6020030

Cited by 30 publications

(21 citation statements)

References 62 publications

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“…Collaborative communication between providers and patients is viewed as a key element in achieving favorable health outcomes in disease management [30]. However, challenges around adequate communication and the ability to access timely health-related information continue to be a barrier to optimal type 1 diabetes care for youth [31].…”

Section: Discussionmentioning

confidence: 99%

“…However, challenges around adequate communication and the ability to access timely health-related information continue to be a barrier to optimal type 1 diabetes care for youth [31]. The use of technology has been recommended as an avenue for improving communication with adolescents [30]. Youth in this study provided insights into their specific communication preferences on the basis of the perceived affordances of social media, and they expressed a clear interest in using some features of social media platforms to facilitate increased contact outside of clinic visits.…”

Section: Discussionmentioning

confidence: 99%

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Adolescent Perspectives on the Use of Social Media to Support Type 1 Diabetes Management: Focus Group Study

et al. 2019

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Background A majority of adolescents report the use of some form of social media, and many prefer to communicate via social networking sites. Social media may offer new opportunities in diabetes management, particularly in terms of how health care teams provide tailored support and treatment to adolescents with diabetes. Objective The aim of this study was to explore the experiences and perspectives of adolescents with type 1 diabetes on the feasibility of social media use as a tool to collaboratively manage their diabetes with their diabetes care team. Methods Focus groups of adolescents with type 1 diabetes were conducted in the Seattle metropolitan area in Washington State. Semistructured questions were used to elicit views around the preferred means of communication with the adolescents’ diabetes care team, how to best support diabetes self-management, and how social media could be used outside of the clinic setting by the diabetes care team to engage with adolescents with type 1 diabetes. Focus groups were audio recorded and transcribed verbatim. Qualitative content analysis was carried out, and emergent themes were subsequently mapped onto 4 domains of feasibility, which included acceptability, demand, implementation, and practicality. Results Participants included 45 adolescents with type 1 diabetes (mean age 15.9, SD 1.7 years; 58% male; diabetes duration mean 6.2, SD 3.6 years; 76% on insulin pumps; 49% wore continuous glucose monitors; 93% reported use of social media; 84% used smartphones as the primary means for social media access). A total of 7 major topics were identified and mapped onto areas consistent with our focus on feasibility. For acceptability and demand, participants expressed how communication over social media could help facilitate (1) improved communication outside of clinic visits to optimize diabetes management, (2) independence in diabetes self-management, (3) connection to other youth with diabetes for additional diabetes support, and (4) delivery of more timely and personalized care. Addressing implementation and practicality, participants shared the need to (1) ensure patient privacy, (2) maintain professional nature of provider-patient relationship, and (3) recognize that social media is not currently used for medical care by youth with diabetes. Conclusions Adolescents with type 1 diabetes expressed interest in the use of social media as a tool to support diabetes management and increase engagement with their diabetes care team. Specific implementation measures around privacy and professionalism should be considered when developing a social media intervention to facilitate communication between adolescents and care teams.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Adolescent Perspectives on the Use of Social Media to Support Type 1 Diabetes Management: Focus Group Study

et al. 2019

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“…Given the differences between initiating a healthy behavior such as exercise and receiving instructions for posthospital care versus potential consequences of poor glycemic control [44], this suggests that Ragts may be an acceptable way to extend care for a variety of diverse behaviors outside of traditional settings. In the management of a chronic condition, such as T1D, patient-provider communication is an essential component of care [45]. Therefore, our goal was not to supplant this relationship but to extend care outside the clinical setting.…”

Section: Discussionmentioning

confidence: 99%

“…The exception was their stronger preference for talking with their doctor or nurse, rather than Ashley, about T1D. As discussed above, given that the patient-provider relationship is essential to the care of T1D, particularly in adolescents [45], this finding is not surprising. The goal when working with chronic disease management should not be to supplant or interfere with the patient-provider relationship but to augment and support it and extend care beyond the clinical setting.…”

Section: Discussionmentioning

confidence: 99%

Using Relational Agents to Promote Family Communication Around Type 1 Diabetes Self-Management in the Diabetes Family Teamwork Online Intervention: Longitudinal Pilot Study

Thompson¹,

Callender²,

Gonynor³

et al. 2019

J Med Internet Res

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BackgroundFamily conflict can reduce adolescent adherence to type 1 diabetes management tasks. The Family Teamwork in-person intervention was shown to be efficacious in reducing conflict and low adherence to diabetes-related tasks. Its reach and potential impact, however, were limited by the need to deliver the intervention sessions in person. Relational agents (ie, computerized versions of humans) have been shown to appeal to diverse audiences and may be an acceptable replacement for a human in technology-based behavior change interventions.ObjectiveThe purpose of this paper is to present the results of a pilot study assessing feasibility and acceptability of Diabetes Family Teamwork Online, an adapted version of the Family Teamwork intervention, delivered over the internet and guided by a relational agent.MethodsParent-adolescent dyads were recruited through a diabetes care clinic at a large tertiary care hospital in the southwestern United States. A one-group design, with assessments at baseline, immediate postintervention, and 3 months later, was used to assess feasibility. A priori feasibility criteria included an assessment of recruitment, completion, attrition, program satisfaction, therapeutic alliance, attitudes toward the relational agent, and data collection. The institutional review board at Baylor College of Medicine approved the protocol (H-37245).ResultsTwenty-seven adolescents aged 10 to 15 years with type 1 diabetes and their parents were enrolled. Criteria used to assess feasibility were (1) recruitment goals were met (n=20), (2) families completed ≥75% of the modules, (3) attrition rate was ≤10%, (4) program satisfaction was high (≥80% of families), (5) therapeutic alliance was high (average score of ≥60/84), (6) families expressed positive attitudes toward the relational agent (average item score of ≥5 on ≥4 items), (7) ≥80% of data were collected at post 1 and post 2, and (8) few technical issues (≤10%) occurred during intervention delivery. All feasibility criteria were met. Qualitative data confirmed that adolescents and parents had positive reactions to both the content and approach.ConclusionsThe Diabetes Family Teamwork Online intervention proved to be a feasible and acceptable method for enhancing communication around diabetes management tasks in families with an adolescent who has type 1 diabetes.International Registered Report Identifier (IRRID)RR2-10.2196/resprot.5817

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“…Indeed, evidence indicates that there are strong positive relationships between a healthcare team communication with the patient and patient satisfaction, adherence to treatment plan, and improved health outcomes. [22][23][24] Our findings have a significant implication on how providers should manage diabetic patients, particularly those with complications, disabilities, and coexisting chronic conditions. The current structure of care focuses narrowly on measures with a minimal impact on the overall wellbeing of patients with a diverse combination of chronic diseases.…”

Section: Discussionmentioning

confidence: 99%

Association Between the Rate of Diabetes and Quality of Patient Care in Home Health Agencies

Zikos

Ogunneye

DeLellis

et al. 2018

Home Health Care Management & Practice

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The multitude of comorbidities and disabilities that are prevalent among diabetic patients make their care very challenging for providers. This, in turn, may have a negative effect on measures of patient satisfaction, quality, and outcomes. This study examines the correlation between diabetes ratio as a primary diagnosis in home health agencies (HHAs) with the Home Health Care Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) survey and the Outcome and Assessment Information Set (OASIS) star ratings. Our result indicates that HHAs with a higher proportion of patients with diabetes have lower ratings in health outcomes (bathing, breathing, moving from the bed, moving around, and controlling pain). The association was stronger in the case of diabetic cases with complications.

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Importance of Patient–Provider Communication to Adherence in Adolescents with Type 1 Diabetes

Cited by 30 publications

References 62 publications

Adolescent Perspectives on the Use of Social Media to Support Type 1 Diabetes Management: Focus Group Study

Adolescent Perspectives on the Use of Social Media to Support Type 1 Diabetes Management: Focus Group Study

Using Relational Agents to Promote Family Communication Around Type 1 Diabetes Self-Management in the Diabetes Family Teamwork Online Intervention: Longitudinal Pilot Study

Association Between the Rate of Diabetes and Quality of Patient Care in Home Health Agencies

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