CoYoT1 Clinic: Home Telemedicine Increases Young Adult Engagement in Diabetes Care

Abstract

Delivering diabetes care by home telemedicine increases young adults' adherence to ADA guidelines and usage of diabetes technologies, and improves retention in care when compared to controls. Home telemedicine may keep young adults engaged in their diabetes care during this challenging transition period.

Adapting home telehealth group appointment model (CoYoT1 clinic) for a low SES, publicly insured, minority young adult population with type 1 diabetes

“…From the Colorado pilot studies, we learned logistical lessons to improve the model and its future implementation [26]. For example, the original device download process was challenging, because it lacked a single platform to integrate diabetes data across devices.…”

“…In our pilot study [26], CoYoT1 Clinic proved feasible and acceptable for YA with T1D, resulting in high levels of satisfaction and completion of all components of the clinic (both the individual provider visits and group appointments). The majority of patients involved in the pilot successfully downloaded their diabetes device data (77%); and completed routine labs at a local lab, hospital, clinic, or other location of their choosing prior to their appointments (88%).…”

“…Our initial study of the CoYoT1 Care model was a feasibility pilot of the various intervention components [24,26]. For the next phase, the mixed methods review suggested testing the care delivery method and the therapy model separately, resulting in a 2 × 2 factorial study design (Table 2).…”

Virtual Coaching to Enhance Diabetes Care

“…12 In another study on 18-55-year-old patients with T1D, there was a tendency toward less impact of diabetes on quality of life in the group receiving telemedicine visits (P = 0.061). 13 Additional benefits of telemedicine were increased attendance at visits, 15,16 less time spent traveling to and attending visits, 11,13,17,18 and lower cost. 11,13 In addition, the use of telemedicine versus in-person visits did not affect the therapeutic relationship between providers and adolescent patients 19 and may actually empower patients to better manage their diabetes.…”

“…11,13 In addition, the use of telemedicine versus in-person visits did not affect the therapeutic relationship between providers and adolescent patients 19 and may actually empower patients to better manage their diabetes. 13,17,18 Virtual environments, which are Internet-based real-time computer-generated three-dimensional representations of a contrived or natural environment in which patients and clinicians self-represent as avatars, 20 are also being studied as a means of providing diabetes self-management (DSM) education to a greater number of individuals. Preliminary results suggest that virtual environments may be another viable means of overcoming both a shortage of diabetes clinicians and barriers to accessing in-office care.…”