Shared and individual medical appointments for children and adolescents with type 1 diabetes; differences in topics discussed?

Objective: The purpose of this study was to examine differences in the type of topics discussed during shared medical appointments (SMAs) and traditional individual outpatient visits for children and adolescents with type 1 diabetes. In addition, differences between the conversational contributions of the participants were examined. Methods: Videotapes of 42 individual outpatient visits and 5 SMAs with 31 children or adolescents were collected and observed using a checklist of topics adapted from the international consensus guideline for the management of type 1 diabetes in childhood and adolescents. Furthermore, patients reported about their experience with the information and support provided during an SMA. Data analysis was performed using one-way ANOVAs and univariate variance analysis. Results: In SMAs, more diabetes-related topics were discussed. During SMAs, the conversational contributions of the different participants seemed to be more equally distributed than during traditional individual outpatient visits. Participants felt that they had learned most from the presence of other patients and their questions. Conclusion: More diabetes-related topics are covered in SMAs than in individual outpatient pediatric follow-up visits. Practice implication: SMAs seem to offer an appreciated variation on the regular diabetes care for children and adolescents. (C) 2010 Elsevier Ireland Ltd. All rights reserved.