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

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.

5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes:Standards of Care in Diabetes—2023

“…Psychosocial interventions can be delivered via digital health platforms (356). Groupbased or shared diabetes appointments that address both medical and psychosocial issues relevant to living with diabetes are a promising model to consider (327,357).…”

Effectiveness of resilience-promoting interventions in adolescents with diabetes mellitus: a systematic review and meta-analysis

“…2 ). The remaining 18 articles met our eligibility criteria [ 28 – 35 , 37 , 41 – 49 ]. In addition, according to the manual search, we found one eligible article [ 36 ].…”

“…For the characteristics of the intervention, the main form of intervention was face-to-face educational sessions ( n = 12), and two studies used interviews [ 42 , 46 ]. Only three studies used online or remote interventions [ 35 , 36 , 45 ]. The most common frequency of intervention was once a week ( n = 6).…”

“…1 and 2. The quality of the included studies was variable, and 12 of them had some concerns about the overall risk of bias [ 28 – 32 , 36 , 37 , 44 , 46 – 49 ], while two each had low [ 33 , 34 ] and five had a high risk of bias [ 35 , 41 – 43 , 45 ]. Because such interventions cannot be blinded to participants, all of the studies we assessed had a low risk of bias in the blinding of participants.…”

“…However, the results of these interventions in improving patient health-related outcomes have been unstable. Some studies showed that these interventions could improve HbA1c [ 28 , 32 – 34 ], but other studies confirmed that the improvement in HbA1c was not significant [ 35 – 37 ]. It is well-known that HbA1c is the standard indicative variable for blood glucose control.…”