Parents of youth with T1D typically prefer a virtual visit to initiate CGM

Amid a steady increase in the use of telemedicine in the healthcare sector, researchers of a new study have found that most parents of children starting continuous glucose monitoring (CGM) are satisfied with the training method.

The interview-based study gathered feedback from 16 parents of 15 youth newly diagnosed with type 1 diabetes, finding that the majority preferred a virtual visit to initiate CGM over an in-person visit. The researchers note that due to their small sample size, their findings may have limited generalizability.

“Findings from this study are consistent with recent literature demonstrating the acceptability and benefits of telehealth-based diabetes care delivery, which is increasingly becoming a recommended pathway to increase access to care, increase visit frequency, while minimizes travel and time, and for remote monitoring of patients between visits,” the researchers wrote. “The SARS-CoV-2 pandemic has led to a rapid acceleration in the expansion of the use of telehealth-based care and highlighted its potential as a major paradigm shift in diabetes care, as well as some challenges (eg, risk of widening disparities and gaps in access, particularly with rural populations; concern for less personalized care over time; lower levels of anthropometric and laboratory measurements).’

The study, initiated to explore families’ perspectives following this acceleration of telemedicine in diabetes care, follows an initial qualitative study of in-person CGM initiation within one month of diagnosis, which found that early initiation of the technology was viewed as important and offering benefits to both parents and youth.

In the current interviews, the parent group indicated that starting CGM through telemedicine visits was convenient for receiving high-quality care. Parents report that they are pleased that they did not have to drive extra for the appointment; some lived up to 3 hours away from the clinic.

Parents also reported feeling that the initiation method offered unique advantages, including reducing anxiety for their young children by allowing them to receive care at home. Parents of teenagers also reported that introducing the CGM system at home, in a setting where they would continue to use the technology every day, increased their child’s confidence and encouraged self-efficacy.

During interviews, some parents indicated a preference for clinics to offer a choice between in-person or virtual visits, reporting that an in-person birth would increase their comfort with the CGM system.

“More research may be needed to better understand which factors determine preferences for in-person or telehealth care, as well as to understand who may benefit from one modality over the other and for what type of visit (e.g. initiation of the device against routine examinations). Recent work in other health care contexts (eg, primary care, mental health care) suggests that several different priorities may determine patient preferences for telehealth or in-person, including time to appointment; the severity of the problem; relationship with their provider; and lack of time for personal visitation, among others.”

Challenges related to virtual care reported by some parents included trying to learn how to apply the first sensor from the doctor via the computer screen and feeling increased anxiety/fear of making a mistake when applying the first sensor.

Another challenge reported by parents is the feeling that the visit is long with an overwhelming amount of information, although the researchers note that this is not unique to virtual visits.

reference

Tanenbaum M, Zaharieva D, Addala A, et al. “Much more convenient, just as effective”: experience of initiating remote continuous glucose monitoring after diagnosis of type 1 diabetes. Diabetic Med. Published online 28 July 2022 doi:10.1111/dme.14923