Home-Based Video Visits Useful for Pediatric Patients With Poorly Controlled Type 1 Diabetes

Pediatric patients with poorly controlled type 1 diabetes (T1D) consider home-based video visits with healthcare providers to be feasible and satisfactory, according to study results published in the Journal of Telemedicine and Telecare.

To evaluate the feasibility of home-based video visits for pediatric patients with T1D who might benefit from more frequent contact with their healthcare providers, researchers provided 6 months of home-based video visits to 57 children and adolescents with T1D who had poor glycemic control (hemoglobin A1c [HbA1c] ≥8%).

Each participant was offered a video visit (median duration, 33 minutes) every 4 to 8 weeks in addition to regularly scheduled clinic visits. The frequency of video visits was based on HbA1c level at baseline, with more frequent visits given to patients with worse glycemic control. The researchers recorded dates of clinic visits and HbA1c values at baseline and 6 months and surveyed participants at study conclusion to assess satisfaction with video visits.

Of the patients enrolled, 36 participants completed the entire 6 months of video visits, with an average rate of 4 visits per person. Frequency of in-person care increased from 3.2 clinic visits each year at baseline to 3.7 each year during the study (P =.04). Including clinic and video visits, the overall average rate of visits was 11.6 each year.

Participants who completed the trial saw an average HbA1c reduction of 0.8%. According to the survey at study end, 94% of participants reported being “very satisfied” and 6% “somewhat satisfied” with the experience of video visits. In addition, 42% cited “advice or encouragement given by the doctor” as the most beneficial aspect, and 31% cited “the doctor’s changes to my insulin doses.”

Limitations to this study included its nonrandomized design and high dropout rate.

In summarizing their findings, the researchers said, “[w]e feel that the application of existing technology to improve care access and outcomes for pediatric patients with T1D presents an opportunity to achieve the Institute for Healthcare Improvement’s ‘triple aim’ of improving health, improving patient experience, and reducing costs.”

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Reference

Crossen S, Glaser N, Sauers-Ford H, Chen S, Tran V, Marcin J. Home-based video visits for pediatric patients with poorly controlled type 1 diabetes [published online March 14, 2019]. J Telemed Telecare. doi:10.1177/1357633X19828173