Tamara Spaic1,2,3, Tracy Robinson4, Ellen Goldbloom5,6, Patricia Gallego3,4,7, Irene Hramiak8,2,3, Margaret L Lawson5,6, Janine Malcolm6,9, Jeffrey Mahon8,2,3, Deric Morrison8,2, Amish Parikh10, Angelo Simone10, Robert Stein4,7, Artem Uvarov2,11, Cheril Clarson. 1. Division of Endocrinology and Metabolism, St. Joseph's Health Care London, London, Ontario, Canada tamara.spaic@sjhc.london.on.ca. 2. Department of Medicine, Western University, London, Ontario, Canada. 3. Lawson Health Research Institute, London, Ontario, Canada. 4. Children's Hospital, London Health Sciences Centre, London, Ontario, Canada. 5. Division of Endocrinology and Metabolism, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada. 6. University of Ottawa, Ottawa, Ontario, Canada. 7. Department of Paediatrics, Western University, London, Ontario, Canada. 8. Division of Endocrinology and Metabolism, St. Joseph's Health Care London, London, Ontario, Canada. 9. The Ottawa Hospital, Ottawa, Ontario, Canada. 10. Trillium Health Partners, Mississauga, Ontario, Canada. 11. Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.
Abstract
OBJECTIVE: To determine if a structured transition program for young adults with type 1 diabetes improves clinic attendance, glycemic control, diabetes-related distress, quality of life, and satisfaction with care. RESEARCH DESIGN AND METHODS: In this multicenter randomized controlled trial, young adults (17-20 years) with type 1 diabetes were randomly assigned to a transition program with a transition coordinator or to standard care. The intervention lasted 18 months (6 in pediatric and 12 in adult care). The primary outcome was the proportion of participants who failed to attend at least one adult diabetes clinic visit during the 12-month follow-up after completion of the intervention. RESULTS: We randomized 205 participants, 104 to the transition program and 101 to standard care. Clinic attendance was improved in the transition program (mean [SD] number of visits 4.1 [1.1] vs. 3.6 [1.2], P = 0.002), and there was greater satisfaction with care (mean [SD] score 29.0 [2.7] vs. 27.9 [3.4], P = 0.032) and less diabetes-related distress (mean [SD] score 1.9 [0.8] vs. 2.1 [0.8], P = 0.049) reported than in standard care. There was a trend toward improvement in mean HbA1c (8.33% [68 mmol/mol] vs. 8.80% [73 mmol/mol], P = 0.057). During the 12-month follow-up, there was no difference in those failing to attend at least one clinic visit (P = 0.846), and the mean change in HbA1c did not differ between the groups (P = 0.073). At completion of follow-up, the groups did not differ with respect to satisfaction with care or diabetes-related distress and quality of life. CONCLUSIONS: Transition support during this 18-month intervention was associated with increased clinic attendance, improved satisfaction with care, and decreased diabetes-related distress, but these benefits were not sustained 12 months after completion of the intervention.
RCT Entities:
OBJECTIVE: To determine if a structured transition program for young adults with type 1 diabetes improves clinic attendance, glycemic control, diabetes-related distress, quality of life, and satisfaction with care. RESEARCH DESIGN AND METHODS: In this multicenter randomized controlled trial, young adults (17-20 years) with type 1 diabetes were randomly assigned to a transition program with a transition coordinator or to standard care. The intervention lasted 18 months (6 in pediatric and 12 in adult care). The primary outcome was the proportion of participants who failed to attend at least one adult diabetes clinic visit during the 12-month follow-up after completion of the intervention. RESULTS: We randomized 205 participants, 104 to the transition program and 101 to standard care. Clinic attendance was improved in the transition program (mean [SD] number of visits 4.1 [1.1] vs. 3.6 [1.2], P = 0.002), and there was greater satisfaction with care (mean [SD] score 29.0 [2.7] vs. 27.9 [3.4], P = 0.032) and less diabetes-related distress (mean [SD] score 1.9 [0.8] vs. 2.1 [0.8], P = 0.049) reported than in standard care. There was a trend toward improvement in mean HbA1c (8.33% [68 mmol/mol] vs. 8.80% [73 mmol/mol], P = 0.057). During the 12-month follow-up, there was no difference in those failing to attend at least one clinic visit (P = 0.846), and the mean change in HbA1c did not differ between the groups (P = 0.073). At completion of follow-up, the groups did not differ with respect to satisfaction with care or diabetes-related distress and quality of life. CONCLUSIONS: Transition support during this 18-month intervention was associated with increased clinic attendance, improved satisfaction with care, and decreased diabetes-related distress, but these benefits were not sustained 12 months after completion of the intervention.
Authors: Sonia Butalia; Susan G Crawford; K Ashlee McGuire; David K Dyjur; Julia R Mercer; Danièle Pacaud Journal: Diabetologia Date: 2021-01-13 Impact factor: 10.122
Authors: Aarooran Sritharan; Uchechukwu L Osuagwu; Manjula Ratnaweera; David Simmons Journal: Int J Environ Res Public Health Date: 2021-12-01 Impact factor: 3.390
Authors: Eimear C Morrissey; Molly Byrne; Bláthín Casey; Dympna Casey; Paddy Gillespie; Anna Hobbins; Michelle Lowry; Elizabeth McCarthy; John Newell; Davood Roshan; Shikha Sharma; Sean F Dinneen Journal: Pilot Feasibility Stud Date: 2022-03-08
Authors: Alexa Marr; Anne Tsampalieros; Jennilea Courtney; Jemila Seid Hamid; Josee St-Denis-Murphy; Liz Stevens; Alexandra Ahmet; Ellen B Goldbloom Journal: BMJ Open Qual Date: 2022-01