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Diabetes Technol Ther. 2018 May;20(5):370-379. doi: 10.1089/dia.2017.0450. Epub 2018 Apr 19.

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

Author information

1
1 Department of Surgery, Division of Ophthalmology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California , Los Angeles, California.
2
2 Department of Pediatrics, Barbara Davis Center for Diabetes, University of Colorado , Aurora, Colorado.
3
3 Department of Telehealth, School of Medicine, University of Colorado , Aurora, Colorado.
4
4 Department of Psychiatry, School of Medicine, University of Colorado , Aurora, Colorado.
5
5 Department of Epidemiology, School of Public Health, University of Colorado , Aurora, Colorado.
6
6 Department of Pediatrics, Division of Endocrinology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California , Los Angeles, California.

Abstract

BACKGROUND:

Young adults with type 1 diabetes (T1D) experience poor glycemic control, disengagement in care, and are often lost to the medical system well into their adult years. Diabetes providers need a new approach to working with the population. The goal of this study was to determine whether an innovative shared telemedicine appointment care model (CoYoT1 Clinic [pronounced as "coyote"; Colorado Young Adults with T1D]) for young adults with T1D improves care engagement, satisfaction, and adherence to American Diabetes Association (ADA) guidelines regarding appointment frequency.

SUBJECTS AND METHODS:

CoYoT1 Clinic was designed to meet the diabetes care needs of young adults (18-25 years of age) with T1D through home telemedicine. Visits occurred every 3 months over the 1-year study (three times by home telemedicine and one time in-person). Outcomes were compared to patients receiving treatment as usual (control).

RESULTS:

Compared with controls, CoYoT1 patients attended significantly more clinic visits (Pā€‰<ā€‰0.0001) and increased their number of clinic visits from the year before the intervention. Seventy-four percent of CoYoT1 patients were seen four times over the 12-month study period, meeting ADA guidelines, but none in the control group met the ADA recommendation. CoYoT1 patients used diabetes technologies more frequently and reported greater satisfaction with care compared with controls.

CONCLUSIONS:

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.

KEYWORDS:

Diabetes; Group appointments; Shared medical appointments; Telehealth; Telemedicine; Young adults

PMID:
29672162
DOI:
10.1089/dia.2017.0450
[Indexed for MEDLINE]

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