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Smartphone App to Deliver Virtual Follow-up Care for Children with Type 1 Diabetes During the COVID-19 Pandemic: Experience in a Resource-Limited Setup

Received: 5 April 2021    Accepted: 14 April 2021    Published: 26 April 2021
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Abstract

COVID-19 pandemic has forced the medical fraternity to quickly adopt telemedicine for patient care. However, the feasibility and utility of smartphone app-based telecare for children with type 1 diabetes (T1D) in resource-limited settings is scarcely reported. A web-based survey, developed with “Google forms”, was sent to parents via the smartphone app WhatsApp, and the responses to the 12 coded questionnaire items were analyzed. The multiple-choice questions were related to the experiences, satisfaction, and expectations regarding the follow-up care delivered to children with T1D between April and November 2020. A total of 578 queries were resolved through WhatsApp during the study period. These were mostly related to reviewing reports, insulin titration, or other minor ailments. From 332 participants in the two WhatsApp groups, 183 responses (55.1%) were collected. The majority of respondents found the WhatsApp telecare model as easy to learn (69.4), simple to use (68.3%) and were overall satisfied (64.5%). None of the families reported that they would recommend against the use of telecare through WhatsApp. Most of them (45.9%) felt that this model could be used in addition to their physical follow-up visits. However, only 15.3% felt that this model could replace all clinic visits in the future. Only 12% of the respondents reported technical difficulties. In conclusion, virtual follow-up care delivered through WhatsApp is feasible and acceptable to families of children with T1D. The minor challenges related to internet access and low literacy levels were easily overcome. WhatsApp-based virtual visits may complement physical visits to the clinic, especially for patients from remote areas.

Published in International Journal of Diabetes and Endocrinology (Volume 6, Issue 2)
DOI 10.11648/j.ijde.20210602.12
Page(s) 64-68
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

COVID-19 Pandemic, Telemedicine, WhatsApp, Type 1 Diabetes, Follow-up Visits, Children

References
[1] Badawy SM, Radovic A. Digital Approaches to Remote Pediatric Health Care Delivery During the COVID-19 Pandemic: Existing Evidence and a Call for Further Research. JMIR Pediatr Parent. 2020; 3: e20049.
[2] Giansanti D. WhatsApp in mHealth: an overview on the potentialities and the opportunities in medical imaging. Mhealth. 2020; 6: 19.
[3] Gupta BM, Dayal D. Pediatric type 1 diabetes research in the 21st century: a scientometric review. Pediatr Endocrinol Diabetes Metab. 2020; 26: 132-139.
[4] Dayal D, Gupta S, Raithatha D, Jayashree M. Missing during COVID-19 lockdown: Children with onset of type 1 diabetes. Acta Paediatr. 2020; 109: 2144-2146.
[5] Dayal D, Gupta S, Raithatha D, Soni P, Kumar S, Baranwal A. Near-fatal experience due to delayed diagnosis of type 1 diabetes during the COVID-19 pandemic. April 28, 2020, Preprint (Version 1). Available at Research Square https://doi.org/:10.21203/rs.3.rs-25337/v1.
[6] Dayal D, Yadav A. COVID-19: Considerations for children and adolescents with diabetes. J Diabetol. 2020; 11: 126-130.
[7] March CA, Flint A, DeArment D, Gilliland A, Kelly K, Rizzitano E, et al. Paediatric diabetes care during the COVID-19 pandemic: Lessons learned in scaling up telemedicine services. Endocrinol Diabetes Metab. 2020: e00202.
[8] Dayal D, Saini AG, Jayashree M, Singhi S, Kumar R, Samprati M, Singh M. Hospital based incidence, patterns of presentation and outcome of Type 1 diabetes: 12 years’ data from a tertiary care center in North India. Int J Diabetes Dev Ctries. 2015; 35: 103–107.
[9] Fung A, Irvine M, Ayub A, Ziabakhsh S, Amed S, Hursh BE. Evaluation of telephone and virtual visits for routine pediatric diabetes care during the COVID-19 pandemic. J Clin Transl Endocrinol. 2020; 22: 100238.
[10] De Guzman KR, Snoswell CL, Taylor ML, Senanayake B, Haydon HM, Batch JA, et al. A systematic review of pediatric telediabetes service models. Diabetes Technol Ther. 2020; 22: 623–38.
[11] Zabeen B, Bhowmik B, Huda K, Naz F, Tayyeb S, Azad K. Use of Telemedicine for the Management of Type 1 Diabetes in Children and Adolescents in Bangladesh During the COVID-19 Pandemic. J Diabetol. 2021; 12: 18–21.
[12] Parmanto B, Lewis AN Jr, Graham KM, Bertolet MH. Development of the Telehealth Usability Questionnaire (TUQ). Int J Telerehabil. 2016; 8: 3-10.
[13] Faruque LI, Wiebe N, Ehteshami-Afshar A, Liu Y, Dianati-Maleki N, Hemmelgarn BR, et al. Effect of telemedicine on glycated hemoglobin in diabetes: A systematic review and meta-analysis of randomized trials. CMAJ. 2017; 189: E341–64.
[14] Banerjee M, Chakraborty S, Pal R. Teleconsultation and Diabetes Care Amid COVID-19 Pandemic in India: Scopes and Challenges. J Diabetes Sci Technol. 2020; 14: 714-715.
[15] Fogel JL, Raymond JK. Implementing Telehealth in Pediatric Type 1 Diabetes Mellitus. Pediatr Clin North Am. 2020; 67: 661–664.
[16] Peters AL, Garg SK. The Silver Lining to COVID-19: Avoiding Diabetic Ketoacidosis Admissions with Telehealth. Diabetes Technol Ther. 2020; 22: 449–453.
[17] Telemedicine Practice Guidelines Enabling Registered Medical Practitioners to Provide Healthcare Using Telemedicine. March 25, 2020, MoHFW, Government of India. Available at: https://www.mohfw.gov.in/pdf/Telemedicine.pdf. Accessed January 8, 2021.
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  • APA Style

    Latika Rohilla, Priyanka Walia, Gurpreet Kaur, Saniya Gupta, Atul Gupta, et al. (2021). Smartphone App to Deliver Virtual Follow-up Care for Children with Type 1 Diabetes During the COVID-19 Pandemic: Experience in a Resource-Limited Setup. International Journal of Diabetes and Endocrinology, 6(2), 64-68. https://doi.org/10.11648/j.ijde.20210602.12

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    ACS Style

    Latika Rohilla; Priyanka Walia; Gurpreet Kaur; Saniya Gupta; Atul Gupta, et al. Smartphone App to Deliver Virtual Follow-up Care for Children with Type 1 Diabetes During the COVID-19 Pandemic: Experience in a Resource-Limited Setup. Int. J. Diabetes Endocrinol. 2021, 6(2), 64-68. doi: 10.11648/j.ijde.20210602.12

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    AMA Style

    Latika Rohilla, Priyanka Walia, Gurpreet Kaur, Saniya Gupta, Atul Gupta, et al. Smartphone App to Deliver Virtual Follow-up Care for Children with Type 1 Diabetes During the COVID-19 Pandemic: Experience in a Resource-Limited Setup. Int J Diabetes Endocrinol. 2021;6(2):64-68. doi: 10.11648/j.ijde.20210602.12

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  • @article{10.11648/j.ijde.20210602.12,
      author = {Latika Rohilla and Priyanka Walia and Gurpreet Kaur and Saniya Gupta and Atul Gupta and Arti Yadav and Pamali Nanda and Jaivinder Yadav and Rakesh Kumar and Nancy Sahni and Devi Dayal},
      title = {Smartphone App to Deliver Virtual Follow-up Care for Children with Type 1 Diabetes During the COVID-19 Pandemic: Experience in a Resource-Limited Setup},
      journal = {International Journal of Diabetes and Endocrinology},
      volume = {6},
      number = {2},
      pages = {64-68},
      doi = {10.11648/j.ijde.20210602.12},
      url = {https://doi.org/10.11648/j.ijde.20210602.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijde.20210602.12},
      abstract = {COVID-19 pandemic has forced the medical fraternity to quickly adopt telemedicine for patient care. However, the feasibility and utility of smartphone app-based telecare for children with type 1 diabetes (T1D) in resource-limited settings is scarcely reported. A web-based survey, developed with “Google forms”, was sent to parents via the smartphone app WhatsApp, and the responses to the 12 coded questionnaire items were analyzed. The multiple-choice questions were related to the experiences, satisfaction, and expectations regarding the follow-up care delivered to children with T1D between April and November 2020. A total of 578 queries were resolved through WhatsApp during the study period. These were mostly related to reviewing reports, insulin titration, or other minor ailments. From 332 participants in the two WhatsApp groups, 183 responses (55.1%) were collected. The majority of respondents found the WhatsApp telecare model as easy to learn (69.4), simple to use (68.3%) and were overall satisfied (64.5%). None of the families reported that they would recommend against the use of telecare through WhatsApp. Most of them (45.9%) felt that this model could be used in addition to their physical follow-up visits. However, only 15.3% felt that this model could replace all clinic visits in the future. Only 12% of the respondents reported technical difficulties. In conclusion, virtual follow-up care delivered through WhatsApp is feasible and acceptable to families of children with T1D. The minor challenges related to internet access and low literacy levels were easily overcome. WhatsApp-based virtual visits may complement physical visits to the clinic, especially for patients from remote areas.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Smartphone App to Deliver Virtual Follow-up Care for Children with Type 1 Diabetes During the COVID-19 Pandemic: Experience in a Resource-Limited Setup
    AU  - Latika Rohilla
    AU  - Priyanka Walia
    AU  - Gurpreet Kaur
    AU  - Saniya Gupta
    AU  - Atul Gupta
    AU  - Arti Yadav
    AU  - Pamali Nanda
    AU  - Jaivinder Yadav
    AU  - Rakesh Kumar
    AU  - Nancy Sahni
    AU  - Devi Dayal
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    JF  - International Journal of Diabetes and Endocrinology
    JO  - International Journal of Diabetes and Endocrinology
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    PB  - Science Publishing Group
    SN  - 2640-1371
    UR  - https://doi.org/10.11648/j.ijde.20210602.12
    AB  - COVID-19 pandemic has forced the medical fraternity to quickly adopt telemedicine for patient care. However, the feasibility and utility of smartphone app-based telecare for children with type 1 diabetes (T1D) in resource-limited settings is scarcely reported. A web-based survey, developed with “Google forms”, was sent to parents via the smartphone app WhatsApp, and the responses to the 12 coded questionnaire items were analyzed. The multiple-choice questions were related to the experiences, satisfaction, and expectations regarding the follow-up care delivered to children with T1D between April and November 2020. A total of 578 queries were resolved through WhatsApp during the study period. These were mostly related to reviewing reports, insulin titration, or other minor ailments. From 332 participants in the two WhatsApp groups, 183 responses (55.1%) were collected. The majority of respondents found the WhatsApp telecare model as easy to learn (69.4), simple to use (68.3%) and were overall satisfied (64.5%). None of the families reported that they would recommend against the use of telecare through WhatsApp. Most of them (45.9%) felt that this model could be used in addition to their physical follow-up visits. However, only 15.3% felt that this model could replace all clinic visits in the future. Only 12% of the respondents reported technical difficulties. In conclusion, virtual follow-up care delivered through WhatsApp is feasible and acceptable to families of children with T1D. The minor challenges related to internet access and low literacy levels were easily overcome. WhatsApp-based virtual visits may complement physical visits to the clinic, especially for patients from remote areas.
    VL  - 6
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Author Information
  • Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Department of Dietetics, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India

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