The Impact of Virtual Care on Health-Related Quality of Life in Pediatric Diabetes Mellitus: A Systematic Review

Background: The COVID-19 pandemic has escalated the utilization of virtual care platforms in pediatric diabetes mellitus. The impact of these interventions on the health-related quality of life (HRQOL) is unclear. Objective: This systematic review evaluated the impact of virtual care, including eHealth and mHealth modalities, when compared to in-person care, on HRQOL in children with diabetes. Methods: MEDLINE, EMBASE, EMCare, PsycInfo, and Web of Science, ProQuest Dissertations and Theses A&I, and ClinicalTrials.gov databases and registries were searched from database inception to October 2^nd, 2023. Randomized and non-randomized comparative studies were eligible for inclusion. Results: Thirteen studies were identified (12 randomized controlled trials, 1 cross-sectional study) involving 1566 children with type 1 diabetes mellitus (T1DM). The supplemental virtual care interventions utilized either web- or mobile-based platforms for intervention implementation. No interventions were detrimental to HRQOL, and a few improved the short-term HRQOL. No interventions worsened glycemic control. Patients and family's satisfaction with virtual care was high, perceiving it to be equal to or better than in-person care. There was no evidence for the use of virtual care and its effect on HRQOL in pediatric type 2 diabetes mellitus patients. Conclusion: Virtual care is associated with a stable or improved HRQOL and patient and family satisfaction in pediatric T1DM. Decision makers need to consider expanding virtual access to pediatric diabetes care that can improve equitable access to quality care across healthcare systems globally.