Smartphone App to Deliver Virtual Follow-up Care for Children with Type 1 Diabetes During the COVID-19 Pandemic: Experience in a Resource-Limited Setup

COVID-19 pandemic has forced the medical fraternity to quickly adopt telemedicine for patient care. However, the feasibility and utility of smartphone app-based telecare for children with type 1 diabetes (T1D) in resource-limited settings is scarcely reported. A web-based survey, developed with “Google forms”, was sent to parents via the smartphone app WhatsApp, and the responses to the 12 coded questionnaire items were analyzed. The multiple-choice questions were related to the experiences, satisfaction, and expectations regarding the follow-up care delivered to children with T1D between April and November 2020. A total of 578 queries were resolved through WhatsApp during the study period. These were mostly related to reviewing reports, insulin titration, or other minor ailments. From 332 participants in the two WhatsApp groups, 183 responses (55.1%) were collected. The majority of respondents found the WhatsApp telecare model as easy to learn (69.4), simple to use (68.3%) and were overall satisfied (64.5%). None of the families reported that they would recommend against the use of telecare through WhatsApp. Most of them (45.9%) felt that this model could be used in addition to their physical follow-up visits. However, only 15.3% felt that this model could replace all clinic visits in the future. Only 12% of the respondents reported technical difficulties. In conclusion, virtual follow-up care delivered through WhatsApp is feasible and acceptable to families of children with T1D. The minor challenges related to internet access and low literacy levels were easily overcome. WhatsApp-based virtual visits may complement physical visits to the clinic, especially for patients from remote areas.