Background: Shared medical appointments (SMA) via home telemedicine may improve clinic attendance and adherence to care recommendations in adolescent and young adult patients (AYA) with type 1 diabetes (T1D). Participation in home telemedicine requires basic health literacy, reliable access to high-speed Internet on a compatible device, and a private location for attending appointments. AYA from households with lower socioeconomic status (SES) may encounter barriers to participation in home telemedicine due to limited resources.

Objective: Evaluate the feasibility of conducting SMA via home telemedicine for low SES AYA with T1D.

Methods: We conducted baseline patient and family assessments as part of a prospective study on the use of SMA and telemedicine for AYA with T1D who attend a pediatric outpatient endocrinology clinic. We calculated SES for each family using a modified version of the Hollingshead index, and dichotomized patients into low and high SES groups.

Results: AYA reported nearly equal interest in attending SMA (Low: 76%; High: 66%), and in completing appointments online (Low: 41%; High: 45%), regardless of SES. Patients reported having access to high-speed Internet (100%), favored home appointments (Low: 35%; High: 42%), and reported having private space (Low: 83%; High: 88%). Low SES patients were younger than high SES patients (15 vs. 17 years, p = 0.01), and reported shorter disease duration (6 vs. 9 years, p < 0.01). Low SES patients reported needing help reading medical information at least sometimes more frequently (76%) than high SES patients (56%, p = 0.05). However, this effect was attenuated in multiple regression analysis, where variations in patients’ health literacy were associated with age (p < 0.05) instead of SES.

Conclusions: Low SES AYA with T1D are equally equipped and interested in utilizing shared telemedicine as high SES patients. Home telemedicine may be a feasible format for diabetes care and psychosocial support for all patients, regardless of SES.

Disclosure

J.J. Flores Garcia: None. M.W. Reid: None. J. Raymond: None.

© 2018 by the American Diabetes Association.
2018
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.