Experiences and Perceptions of Telehealth Visits in Diabetes Care During and After the COVID-19 Pandemic Among Adults With Type 2 Diabetes and Their Providers: Qualitative Study

Experiences of Motivational Interviewing in Virtual Health-care Visits for Adults With Type 2 Diabetes Mellitus: A Qualitative Analysis

OBJECTIVES

The purpose of this qualitative study is to identify barriers minimizing the effectiveness of motivational interviewing during virtual clinic encounters for individuals with type 2 diabetes based on the capability, opportunity, motivation, and behaviour (COM-B) model.

METHODS

One-on-one semistructured interviews were conducted from March to June 2023, with 17 adults with type 2 diabetes (64.7% female; median age 69 years, range 47 to 83 years) followed at St. Michael's Hospital (Toronto, Canada). Themes from transcribed interviews were identified through descriptive analysis using a grounded theory approach.

RESULTS

The following main themes were identified: 1) face-to-face appointments strengthen provider-patient rapport and collaboration; 2) virtual encounters reduce patient accountability and hinder health-seeking behaviour; and 3) individuals with physical disabilities and/or low technological proficiency experience decreased provider accessibility. Protective factors that can mitigate these negative impacts include establishing rapport during in-person appointments before transitioning to virtual appointments and incorporating a video component during virtual encounters.

CONCLUSIONS

Several barriers of virtual appointments currently limit the effectiveness of motivational interviewing for individuals with type 2 diabetes and make it difficult to provide person-centred care, especially by phone. However, there are protective factors that help to maintain healthy lifestyle behaviours, even after transitioning to virtual settings, and are areas for optimization moving forward.

Experiences of people with diabetes mellitus of telehealth for diabetes management during the COVID-19 pandemic: a qualitative systematic review protocol

OBJECTIVE

The objective of this review is to explore the experiences of people with diabetes who utilized telehealth for diabetes management due to COVID-19 pandemic protocols rather than traditional in-person consultations.

INTRODUCTION

COVID-19 intensified globally from January 2020, eliciting a multinational response to infection control for health preservation, including social distancing in public areas and health care settings. The outcome had significant impact on the health care system, where people with chronic diseases, such as those with diabetes, were required to transition a majority of their care to telehealth to align with social restrictions.

INCLUSION CRITERIA

This review will include qualitative and mixed methods studies and theses of any research design and in any language that examine the experiences of adults with diabetes who transitioned from in-person consultations to telehealth during the COVID-19 pandemic. Exclusions include pre-COVID-19 data; quantitative studies; secondary, tertiary, and all other gray literature.

METHODS

A search of CINAHL (EBSCOhost), Scopus, Emcare (Ovid), Embase (Elsevier), PubMed (NCBI), and several ProQuest databases will be conducted. Studies from January 2020 onwards in any language will be assessed for inclusion. Two independent reviewers will retrieve and screen titles and abstracts and full-text studies and assess the methodological quality of the included studies utilizing the JBI qualitative critical appraisal tool. The included studies will be synthesized utilizing JBI meta-aggregation, and the certainty of the findings will be assessed with ConQual.

REVIEW REGISTRATION

PROSPERO CRD42023424667.