Use and Perception of Telemedicine in People with Type 1 Diabetes During the COVID-19 Pandemic: A 1-Year Follow-Up

Abstract

Background: In the spring of 2020, our research group circulated a worldwide survey with the aim of gathering information on the use and perception of telemedicine in people living with type 1 diabetes at the start of the COVID-19 pandemic. The data suggested that a large number of respondents had rapidly adopted to telemedicine, as in-person visits were not possible, and that this was perceived positively by many. In this study, we conducted a 1-year follow-up to investigate changes in opinions and experiences to telemedicine over the past year of the pandemic. Methods: An anonymous questionnaire was distributed through social media (Twitter, Facebook, and Instagram) between May 9 and May 15, 2021, using an open-access web-based platform (SurveyMonkey.com). The survey was identical to that used in the original study, covering questions relating to the use and perception of telemedicine, diabetes treatment and control, and medical supplies during the COVID-19 pandemic. The questionnaire was available in English, Spanish, German, French, and Italian. We compared the results from the two surveys descriptively and statistically, results were stratified according to age, gender, and HbA1c. Results: There were 531 survey responses from 40 countries (Europe 54%, North America 36%, South America 2%, and Africa and Asia 2%). A large percentage of respondents (67%) reported meeting with their health care provider remotely since the beginning of the pandemic, a significant increase compared with the 28% in the 2020 survey (P < 0.001). Eighty-three percent of respondents found remote appointments to be somewhat-to-extremely useful, similar to the 86% satisfaction rate in the previous survey (P = 0.061). Remote appointments were most frequently undertaken through telephone (50%) and video call (45%), which are significant changes compared with those in 2020 (72% and 28%, respectively, P < 0.001). Forty-five percent of respondents in 2021 were likely to consider remote appointments instead of in-person appointments in the future-being significantly lower than the 75% in the initial survey (P < 0.001)-whereas 37% indicated they would not. The majority of respondents (84%) reported no issues in their access to diabetes supplies and medication over the past year. Conclusions: This study showed that the use of telemedicine in the form of remote appointments increased during the COVID-19 pandemic in people living with type 1 diabetes, with high levels of satisfaction. However, a remarkable decline took place in the past year in the proportion of patients stating a willingness to continue with remote appointments beyond the pandemic. It seems that a personalized approach is needed since a substantial proportion of respondents in this follow-up still indicated a preference for in-person diabetes care, hence the use of telemedicine should be considered on an individual basis.