Relations Between the Use of Electronic Health and the Use of General Practitioner and Somatic Specialist Visits in Patients With Type 1 Diabetes: Cross-Sectional Study

Abstract

BackgroundThe prevalence of diabetes and the use of electronic health (eHealth) are increasing. People with diabetes need frequent monitoring and follow-up of health parameters, and eHealth services can be of great value. However, little is known about the association between the use of eHealth and provider-based health care services among people with diabetes.ObjectiveThe objective of this study was to investigate the use of 4 different eHealth platforms (apps, search engines, video services, and social media sites) and associations with the use of provider-based health care visits among people diagnosed with type 1 diabetes mellitus (T1DM).MethodsWe used email survey data collected from 1250 members of the Norwegian Diabetes Association (aged 18 to 89 years) in 2018. Eligible for analyses were the 523 respondents with T1DM. Using descriptive statistics, we estimated the use of eHealth and the use of general practitioners (GPs) and somatic specialist outpatient services. By logistic regressions, we studied the associations between the use of these provider-based health services and the use of eHealth, adjusted for gender, age, education, and self-rated health.ResultsOf the sample of 523 people with T1DM, 90.7% (441/486) had visited a GP once or more, and 61.0% (289/474) had visited specialist services during the previous year. Internet search engines (such as Google) were used for health purposes sometimes or often by 84.0% (431/513), apps by 55.4% (285/514), social media (such as Facebook) by 45.2% (232/513), and video services (such as YouTube) by 23.3% (118/506). Participants aged from 18 to 39 years used all forms of eHealth more than people aged 40 years and older, with the exception of social media. The use of search engines was positively associated with the use of somatic specialist services (odds ratio 2.43, 95% CI 1.33-4.45). GP visits were not associated with any kind of eHealth use.ConclusionseHealth services are now widely used for health support and health information by people with T1DM, primarily in the form of search engines but often in the form of apps and social media as well. We found a positive association between the use of search engines and specialist visits and that people with T1DM are frequent users of eHealth, GPs, and specialist services. We found no evidence that eHealth reduces the use of provider-based health care; these services seem to be additional rather than alternative. Future research should focus on how health care services can meet and adapt to the high prevalence of eHealth use. Our results also indicate that many patients with T1DM do not visit specialist clinics once a year as recommended. This raises questions about collaboration in health care services and needs to be followed up in future research.

Risk conditions in children hospitalized with influenza in Norway, 2017-2019

“…The sensitivity for capturing risk conditions depends on whether all diagnoses on existing conditions are registered during health care visits, and that patients regularly see a doctor for their condition. A Norwegian study in adults found that only 60% of adult patients with diabetes had seen a specialist the last year (42). However, children in Norway with chronic conditions such as diabetes or epilepsy, are very likely to have annual visits and check-ups in specialist care and are thereby expected to be correctly de ned in this registrybased study.…”

Risk conditions in children hospitalized with influenza in Norway, 2017-2019

“…The sensitivity for capturing risk conditions depends on whether all diagnoses on existing conditions are registered during health care visits, and that patients regularly see a doctor for their condition. A Norwegian study in adults found that only 60% of adult patients with diabetes had seen a specialist the last year (43). However, children in Norway with chronic conditions such as diabetes or epilepsy, are very likely to have annual visits and check-ups in specialist care and are thereby expected to be correctly de ned in this registrybased study.…”

Perspectiva de jovens com diabetes sobre intervenção educativa na rede social Facebook®

“…(5) Internationally, the use of digital platforms as a tool for health education in patients with DM has been the object of several studies, which has highlighted the benefits of this use. (6)(7)(8)(9)(10)(11) For example, it has been identified that an important percentageabout 30% -of patients with 1DM and 2DM use Facebook® as the first source of information about the disease. (5) This tool has been used to share personal clinical information, request specific disease guidance and feedback, and also receive emotional support.…”

“…(11,12) Finally, the results of studies point to the possibility of health professionals to use social media to provide support for the education of patients with DM and their caregivers, disseminating useful and safe knowledge and information related to disease treatment and control. (7,11) Given the above and considering the high prevalence of 1DM, there is complexity in the management of this condition, especially by young people. There is a low demand for health services from them, (13) making it imperative to develop actions that overcome traditional care.…”