1928-LB: Understanding the Burden of Digital Care—Field Testing the TBQ+D in Patients Living with Diabetes
Misk Al Zahidy, KERLY GUEVARA MALDONADO, MARIANA BORRAS OSORIO, Megan E. Branda, Jennifer L. Ridgeway, Víctor M. Montori · Diabetes · 2025
Introduction and Objective: Digital medicine tools (e.g., apps, CGM, portals) enable patient self-management and improve diabetes outcomes. Their routine use represents work to patients that can be burdensome. This study aimed to validate the Treatment Burden Questionnaire to assess Digital treatment burden (TBQ+D) in patients with diabetes. Methods: Adults with diabetes who used ≥1 digital medicine tool and received endocrine care at Mayo Clinic were eligible to participate. Recruitment was in-person prior to a clinical visit and surveys were completed on paper. Validity was assessed using associations between TBQ+D scores and social risk factors, digital comfort, and glycemic control. Results: Among 324 approached participants, 300 consented and completed the TBQ+D prior to their visit (median age: 60 years, IQR 45-70; 50% female; 50% with Type 2 diabetes). The TBQ+D demonstrated excellent internal consistency (Cronbach’s α = 0.94).We found higher burden scores in participants with DM1 (mean 61.7, SD 42.3 vs. DM2 45.7 (39.4); p=.0008), those with HbA1c ≥8% (61.1 (40.7) vs. HbA1c <8% (50.8 (42.5); p=.055), and those on intensive insulin therapy (61.4 (41.9) vs. other insulin programs (38.0 (36.6); p=<.0001). Higher social vulnerability but not comfort with digital technology (p=.08), was associated with greater burden (p<.0001). Conclusion: The TBQ+D has evidence of validity and reliability as a novel measure of digital treatment burden in patients living with diabetes. Future research should characterize trajectories of digital burden, evaluate the effects of interventions to reduce digital burden, and the benefits of minimally disruptive care on outcomes that matter to patients with diabetes. Disclosure M. Al Zahidy: None. K. Guevara Maldonado: None. M. Borras Osorio: None. M.E. Branda: None. J.L. Ridgeway: None. V.M. Montori: None. Funding The Center for Digital Health at Mayo Clinic supported this work through funding from the Noaber Foundation (UTA03047).