Short summary

Purpose of the current study is to develop and test an online psychological intervention for patients (>30 years of age) with type-1 diabetes and diabetes distress. The project consists of four phases inspired by Participatory Design: 1. Examination of patients' needs and challenges 2. Development of modules for the online psychological intervention 3. A feasibility study 4. A Model of Assessment of Telemedicine evaluation.

Rationale

BACKGROUND People with diabetes have to manage their disease 24 hours seven days a week. Thus, their management of and well-being with diabetes is crucial for their prognosis. A large responsibility for disease management places great demands on the individual patient, and for some patients all these demands result in the patient being overburdened (termed diabetes distress). At Steno Diabetes Center Odense (SDCO), patient with psychological difficulties in coping with their diabetes can be offered an individual treatment course with a psychologist. However, the recourses are limited, why only the most challenged patients are prioritized. To extent the treatment offers for patients with diabetes distress a therapist-supported online psychological intervention will be developed. The purpose of the online psychology intervention is to allow patients to work independently with large parts of the treatment and thereby preventing the patients' diabetes distress from developing negatively into, for example, anxiety or depression. Research shows that therapist-supported online therapy is as effective as face-to-face therapy. In addition, online therapy has several advantages, including that the patient can work with the intervention whenever and wherever it suits the patient. The online format is scalable and will thus be able to be adapted to several target groups, e.g. people with type 2 diabetes or different psychological difficulties with diabetes, and thereby extending it to several groups and across healthcare sectors. Online-based psychological interventions have mainly been studied among patients with type 2 diabetes. A systematic review and meta-analysis of 18 RCT studies in this patient group has shown a significant improvement with internet-based interventions in relation to diabetes distress, self-efficacy (belief in one's own ability to take action) and HbA1c level. There are only a few studies that have investigated the effect of Internet-based interventions for diabetes distress among patients with type 1 diabetes. A study using Internet-based cognitive behavioral therapy to treat depression among patients with type 1 or type 2 diabetes found that the treatment significantly reduced diabetes distress after 3 months of treatment and that the effect persisted after 3 months of follow-up. A smaller study with 42 patients (type 1 or type 2 diabetes) who investigated an online intervention based on acceptance and commitment therapy (ACT) also found a significant reduction in diabetes distress.

AIM The aim of the project is to develop and test an online psychology intervention for patients with type 1 diabetes and increased diabetes distress. The intervention will be tested in a feasibility study.

Description of the cohort

Patients 30 years or older with type-1 diabetes and high diabetes distress from the out patient clinic at Steno Diabetes Center Odense

Data and biological material

Questionnaire data and data from the patient journal

Collaborating researchers and departments

Center for Digital Psykiatri

• Kim Mathiasen
• Thomas Lambertsen Binzer
• Alberthe Møller
• Nicolai Drejer Walther