(DCP063) TECHNOLOGY-ENABLED COLLABORATIVE CARE FOR DIABETES AND MENTAL HEALTH: LEARNING FROM STUDY FINDINGS AND COMMUNITY PROVIDERS TO ACHIEVE INTEGRATED DIABETES AND MENTAL HEALTH CARE

Background: For individuals living with type-2 diabetes (T2D), mental health issues such as distress, anxiety, and depression are common. However, existing models of care require those living with T2D and mental health issues to navigate a fragmented healthcare system to receive physical and mental health services. To meet the complex needs of those living with T2D and mental health issues, and address the need for clinical integration for this population, the Technology-Enabled Collaborative Care for Diabetes and Mental Health (TECC-D) program was developed with input from three people with lived experience of diabetes, diabetes and mental health providers, and community collaborators.

METHODS AND RESULTS: In this explanatory sequential feasibility trial, the TECC-D program leveraged existing assets including widely available technology (telephone, web-conferencing) to integrate T2D and mental health support through weekly, virtual health coaching sessions with a Certified Diabetes Educator, supported by a multidisciplinary virtual care team for 8 weeks. Primary outcomes included the feasibility and acceptability (i.e., recruitment, retention) of the TECC-D model with exploratory outcomes including changes in mental health, substance use, and other health behaviours collected at baseline, 4, 8, and 12 weeks. Provider and participant experience and satisfaction were also explored through a qualitative descriptive study. Lastly, a series of pan-Canadian workshops with primary and community care providers were hosted to better understand how this program may be scaled-up.

31 participants were recruited and completed the program. Study findings demonstrate that the TECC-D model is a feasible and scalable care solution that empowers individuals living with T2D and mental health issues to take an active role in improving their physical and mental health. Participants and providers described program components (e.g., health coaching, virtual care team) and program delivery (e.g., frequency and duration of the program) positively. Through the dissemination of study findings, an understanding of who may most benefit from this program and how the program could circle-back to primary care providers was gained.

Conclusion: Utilizing widely available technology in the current health system and engaging existing primary and community-based care assets, the TECC-D program was found to be acceptable to participants, providers, and patient partners. Further, this program has demonstrated that achieving integrated, person-driven diabetes and mental health care is not only possible but highly feasible.