Examining Patient Characteristics Associated With Digital Outpatient Care for Type 1 Diabetes (DigiDiaS): Cross-Sectional Study (Preprint)

<sec> <title>BACKGROUND</title> People with type 1 diabetes require ongoing self-management and frequent follow-up care. Digital care models might offer flexible solutions and increased sustainability&lt;i&gt;,&lt;/i&gt; and while the clinical opportunities of these care models have been explored, the characteristics of patients inclined to opt for digital care remain unclear. </sec> <sec> <title>OBJECTIVE</title> This study aimed to investigate which selected sociodemographic and disease-related patient characteristics are associated with opting for digital outpatient care among patients with type 1 diabetes. </sec> <sec> <title>METHODS</title> This cross-sectional study was conducted at the endocrinology department of Akershus University Hospital in Norway, as part of a larger longitudinal study. Adult patients with type 1 diabetes were eligible to participate and were recruited consecutively. Patients could choose either a novel, mobile health–based, digital, tailored, outpatient care model (DigiDiaS care) or continuation of usual care. DigiDiaS care is delivered via an app comprising a message service; preconsultation questionnaires; options for physical, video, or telephone consultations; an information page; and an e-learning course. Sociodemographic and clinical data were collected from the participants’ medical records and the national diabetes registry. Self-reported data comprised self-management measured using the Patient Activation Measure 13 (PAM-13), diabetes distress (20&lt;i&gt;-&lt;/i&gt;item Problem Areas in Diabetes; PAID-20), well-being (World Health Organization-Five Well-Being Index; WHO-5), and health literacy (12-item short version of the European Health Literacy Survey Questionnaire; HLS-19 Q12) questionnaires. We explored group differences and conducted logistic regression to identify factors associated with opting for DigiDiaS care versus usual care. </sec> <sec> <title>RESULTS</title> A total of 237 patients consented to participate in the study, with 185 (78.1%) opting for DigiDiaS care and 52 (21.9%) opting for usual care. The DigiDiaS care group had a statistically significantly shorter duration of diabetes (median 19, range 0-51 years) compared with the usual care group (median 29, range 3-58 years; &lt;i&gt;P&lt;/i&gt;&amp;lt;.001); higher proportions of users of insulin pumps than insulin pens for insulin delivery (DigiDiaS care: 74/185, 40%; usual care: 12/185, 23.1%; &lt;i&gt;P&lt;/i&gt;=.007), and a lower median well-being care score (DigiDiaS care: median score 60, range 4-96; usual care: median score 68, range 16-100; &lt;i&gt;P&lt;/i&gt;=.04). The DigiDiaS care and usual care groups did not differ in sociodemographic variables, presence of late complications from diabetes or comorbidities, self-management, diabetes distress, or health literacy. </sec> <sec> <title>CONCLUSIONS</title> This study reveals that most patients with type 1 diabetes choose digital outpatient care when it is offered. Our study suggests that those opting for DigiDiaS care are already familiar with using diabetes-related technology, have a shorter diabetes duration&lt;i&gt;,&lt;/i&gt; and have lower well-being. It is essential to understand the characteristics of patients who opt for usual care to ensure high-quality health care services. Further studies should also focus on how the implementation of digital solutions in outpatient care can affect how and if patients use them. </sec> <sec> <title>INTERNATIONAL REGISTERED REPORT</title> RR2-10.2196/52766 </sec>