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Diabetes Collaborative Care for Young Adults: A Formative, Mixed Methods Study of a Pragmatic, Multidisciplinary Care
Janaki D Vakharia1, Maria Theodorakakis2, Carolin Schulte3
1Diabetes Unit, Endocrine Division, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
Objectives:
Young adults with diabetes face unique challenges in care. We aimed to assess the feasibility of the Diabetes Collaborative Care for Young Adults (DCCYA), a multidisciplinary care model tailored to young adults.
Methods:
A nonrandomized, two-arm mixed-methods prospective comparison of the DCCYA and usual care (UC) for patients aged 18-30 years old with type 1 or 2 diabetes. The primary outcome was feasibility, measured by DCCYA follow-up visit retention rate compared to UC. Secondary outcomes included change in patient-reported outcome measures and hemoglobin A1c and qualitative reports regarding the diabetes care experience. Data were collected from health records, patient surveys, and semistructured interviews.
Results:
Mean follow-up visit retention rates of DCCYA (n = 16, 62%) and UC arms (n = 29, 52%) at 9 months were comparable (P = .4), though the DCCYA arm had more scheduled follow-up visits (3.9 ± 1.5 vs 2.4 ± 1.3, P = .002). There was no significant change in diabetes-related distress, depressed mood, anxiety, disordered eating, or hemoglobin A1c within or between groups. DCCYA participants reported a positive experience and desire for diabetes-specific insurance guidance, education, and mental health support.
Conclusion:
The DCCYA serves as an example of a feasible, pragmatic model of care that addresses the unique needs of young adults with diabetes.
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