Telehealth strategy to mitigate the negative psychological impact of the COVID-19 pandemic on type 2 diabetes: A randomized controlled trial.

ABSTRACT

AIMS: To assess the impact of teleintervention on mental health parameters in type 2 diabetes patients during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: This is a controlled randomized trial for a multidisciplinary telehealth intervention in Southern Brazil, with social distancing measures. Adults aged 18 years or older with previous diagnosis of type 2 diabetes were included in the study. The intervention performed was a set of strategies to help patients stay healthy during the COVID-19 pandemic and included the maintaining of telephone contacts and providing educational materials on issues related to mental health, healthy habits, and diabetes care. The primary outcome was a positive screening for mental health disorders (Self-Reporting Questionnaire) after 16 weeks of intervention. A positive screening for mental health disorders was considered when the survey scored greater than or equal to 7. Secondary outcomes included a positive screening for diabetes-related emotional distress (Problem Areas in Diabetes), eating (Eating Attitudes Test), and sleep disorders (Mini Sleep Questionnaire). Comparisons with χ2 tests for dichotomous outcomes, along with the Mann-Whitney U test, was used for between group analyses. RESULTS: A total of 91 individuals agreed to participate (46 intervention group and 45 control group). There were no differences in demographic and clinical data at baseline. After 16 weeks of follow-up, a positive screening for mental health disorders was found in 37.0% of participants in the intervention group vs. 57.8% in the control group (P = 0.04). Diabetes-related emotional distress was found in 21.7% of participants in the intervention group vs. 42.2% in the control group (P = 0.03). No differences were found between groups with regard to eating and sleep disorders. CONCLUSION: This study demonstrated that maintaining remote connections with health professionals during social distancing and quarantine have the potential to reduce the prevalence of positive screening for mental health disorders and diabetes-related emotional distress in adults with type 2 diabetes.