Diabetes Mellitus, Type 1
Conditions
Keywords
Pediatrics
Brief summary
At the conclusion of this project, investigators will have assessed the effectiveness of home-based telemedicine for improving multiple important clinical and patient-centered outcomes in a high-risk pediatric cohort with T1D. Aim 1. To test the hypothesis that home-based telemedicine is a feasible and acceptable method of care delivery for patients with poorly controlled type 1 diabetes (T1D) currently cared for at the University of California, Davis (UCD) Pediatric Endocrinology clinic. Specifically: A) Patients and families choose to participate in telemedicine visits as a supplement to in-person care; B) Patients and families can utilize secure, internet-based platforms to upload and share glucose meter data and to establish an audio-video connection with a diabetes specialist in their home settings; C) Patients and families are satisfied with the experience of home-based telemedicine and would choose to receive future diabetes care via this modality. Aim 2. To test the hypothesis that using home-based telemedicine, these patients can complete more frequent visits with a diabetes specialist than they previously completed via office visits alone. Aim 3. To test the hypothesis that increased contact with a diabetes specialist via home-based telemedicine will lead to significant improvement in glycemic control for these patients. Aim 4. To evaluate the effects of increased contact with a diabetes specialist via home-based telemedicine on high-cost health care utilization - specifically emergency department (ED) visits and diabetes-related hospitalizations.
Interventions
BEHAVIORALTelemedicine Intervention
Home-based telemedicine visits
Sponsors
University of California, Davis
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
1 Years to 17 Years
Healthy volunteers
No
Inclusion criteria
* age 1-17 years * known diagnosis of T1D * \>1 prior visit to the UC Davis Pediatric Endocrinology clinic (to avoid enrolling newly diagnosed patients) * suboptimal glycemic control, defined as most recent hemoglobin A1C level of \>8% * access to the internet via a device with video and audio capability (e.g. computer, tablet, mobile phone) * ability to connect their home glucose meter to an internet-capable device via Bluetooth or physical cable for the purpose of data uploading.
Exclusion criteria
* Patients and parents whose primary language is not English * Patients who have Western Health Advantage health insurance
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Improvement in A1C Levels | 12-months | Investigators will compare the mean pre-study and mean post-study A1C levels |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Impact on high-cost health care utilization | 24-months | Investigators will compare the mean number of ED visits and mean number of diabetes-related hospitalizations for patients in the cohort |
| Increased visit frequency | 24-months | Investigators will evaluate if offering telemedicine visits leads to increased visit frequency for these patients during the 12-month study period, when compared to the previous 12-months |
| Feasibility of home-based telemedicine | 12-months | Investigators will evaluate the feasibility of home-based telemedicine for the patient population by the percent of eligible patients who enroll in the study and the percent of enrolled patients who complete the study |
| Acceptability of home-based telemedicine | 12-months | Investigators will evaluate the acceptability of home-based telemedicine for the patient population by the percent of those completing the study who express satisfaction with the telemedicine experience. |
Countries
United States
Outcome results
None listed