Examining Patient Characteristics Associated With Digital Outpatient Care for Type 1 Diabetes (DigiDiaS): Cross-Sectional Study

Abstract

Background: People with type 1 diabetes require ongoing self-management and frequent follow-up care. Digital care models might offer flexible solutions and increased sustainability, and while the clinical opportunities of these care models have been explored, the characteristics of patients inclined to opt for digital care remain unclear. Objective: This study aimed to investigate which selected sociodemographic and disease-related patient characteristics are associated with opting for digital outpatient care among patients with type 1 diabetes. Methods: This cross-sectional study was conducted at the endocrinology department of Akershus University Hospital in Norway, as part of a larger longitudinal study. Adult patients with type 1 diabetes were eligible to participate and were recruited consecutively. Patients could choose either a novel, mobile health–based, digital, tailored, outpatient care model (DigiDiaS care) or continuation of usual care. DigiDiaS care is delivered via an app comprising a message service; preconsultation questionnaires; options for physical, video, or telephone consultations; an information page; and an e-learning course. Sociodemographic and clinical data were collected from the participants’ medical records and the national diabetes registry. Self-reported data comprised self-management measured using the Patient Activation Measure 13 (PAM-13), diabetes distress (20-item Problem Areas in Diabetes; PAID-20), well-being (World Health Organization-Five Well-Being Index; WHO-5), and health literacy (12-item short version of the European Health Literacy Survey Questionnaire; HLS-19 Q12) questionnaires. We explored group differences and conducted logistic regression to identify factors associated with opting for DigiDiaS care versus usual care. Results: A total of 237 patients consented to participate in the study, with 185 (78.1%) opting for DigiDiaS care and 52 (21.9%) opting for usual care. The DigiDiaS care group had a statistically significantly shorter duration of diabetes (median 19, range 0-51 years) compared with the usual care group (median 29, range 3-58 years; P