Structured support aids care transition for teens with type 1 diabetes
SAN DIEGO — A structured program that includes transition coordinators improved clinic attendance and eased emotional burden for adolescents moving from pediatric to adult diabetes care, according to a speaker here.
“Transition is a challenging time for young adults with type 1 diabetes,” Tamara Spaic, MD, MSc, assistant professor, department of medicine, division of endocrinology and metabolism at Western University in Ontario, said during a news briefing. “They transition from the pediatric diabetes care, which is family-oriented, patient-centered care ... to the adult care, which is very fast-paced, problem-oriented care.”
A high rate of dissatisfaction with care persists among teens at this stage. One in three teens drops out of the system during the transition, Spaic said.
The researchers randomly assigned 205 adolescents in Canada with type 1 diabetes to a structured transition care program (n = 104) or standard care (n = 101). Participants were aged 17 to 20 years and were seen in the pediatric setting for 6 months and in the adult setting for the next 12 months. Follow-up was performed over the next 12 months.
The transition program provided patients with a dedicated certified diabetes educator who served as a transition coordinator to help teens navigate the health care system, attend clinic visits, and communicate by email and text messages about specific concerns.
At 18 months, the mean number of contacts with a transition coordinator was 17.6 in the structured-care group. Participants in the structured-care group had attended more clinic visits than the standard-care group (4.1 vs. 3.6; P = .002).
At baseline, all participants completed the Client Satisfaction Questionnaire, the Diabetes Quality of Life Questionnaire and the Diabetes Distress Scale questionnaire. At 18 months, 68.3% of the structured-care group and 56.4% of the standard-care group completed the surveys again. Reported satisfaction with care was 28.9% in the structured-program group vs. 27.9% in the standard-care group (P = .04). In addition, the structured-care group reported less emotional burden related to their diabetes (2.3% vs. 2.7%, P = .03).
Glycemic control was not different between the groups.
Through this study, “we achieved what we set out to do, [which was] to engage those young adults and keep them coming back and regularly follow with their diabetes care providers,” Spaic said. – by Jill Rollet
Spaic T. 292-OR. Presented at: American Diabetes Association 77th Scientific Sessions; June 9-13, 2017; San Diego.
Disclosure : Spaic reports consulting for Eli Lilly Canada and Sanofi Canada; receiving research support from AstraZeneca, Janssen Pharmaceuticals, JDRF Foundation, Lexicon Pharmaceuticals and Novo Nordisk; and speaking for Novo Nordisk and Sanofi Canada.