Optimal Use of Diabetes Devices: Clinician Perspectives on Barriers and Adherence to Device Use.
Optimal Use of Diabetes Devices: Clinician Perspectives on Barriers and Adherence to Device Use.
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DOI：
10.1177/1932296816688010
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发表时间：
2017-05-01
影响因子：
5
通讯作者：
Hood, Korey K
中科院分区：
文献类型：
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作者：
Tanenbaum, Molly L;Adams, Rebecca N;Hood, Korey K
背景：胰岛素泵和动态血糖监测仪（CGM）可以改善1型糖尿病（T1 D）患者的血糖控制。器械使用率继续显示出改进的空间，需要一致的依从性以实现更好的结局。糖尿病医疗服务提供者在促进设备使用和adherence.METHODS中发挥着重要作用：我们调查了209名治疗1型糖尿病患者的临床医生，以检查对设备摄取障碍的看法，对糖尿病技术的态度，以及临床医生改善设备摄取所需的资源。结果：年轻的临床医生使用胰岛素泵（r = -.26，P < .001）和CGM（r = -.14，P = .02）治疗的患者更多，对糖尿病技术的态度更积极（r = -.23，P = .001）。最常认可的可修改障碍是患者不喜欢将设备放在身上（73%泵; 63% CGM）、不喜欢警报（61% CGM）以及不了解如何处理设备信息或功能（40%泵; 46% CGM）。临床医生希望降低成本和更好的保险覆盖范围为他们的病人，他们建议咨询和教育，以帮助解决障碍，提高依从性device.CONCLUSION：临床医生认为许多障碍，他们的病人启动和坚持糖尿病设备。调查结果强调了干预的机会，以改善临床医生与患者围绕设备障碍的沟通，以帮助解决这些问题。
BACKGROUND: Insulin pumps and continuous glucose monitors (CGM) can improve glycemic control for individuals with type 1 diabetes (T1D). Device uptake rates continue to show room for improvement, and consistent adherence is needed to achieve better outcomes. Diabetes health care providers have important roles to play in promoting device use and adherence.METHODS: We surveyed 209 clinicians who treat people with type 1 diabetes to examine perceptions of barriers to device uptake, attitudes toward diabetes technology, and resources needed for clinicians to improve device uptake. We compared findings with our survey of adults with T1D.RESULTS: Younger clinicians treated more patients using insulin pumps ( r = -.26, P < .001) and CGM ( r = -.14, P = .02), and had more positive attitudes about diabetes technology ( r = -.23, P = .001). The most frequently endorsed modifiable barriers were perceptions that patients dislike having the device on their body (73% pump; 63% CGM), dislike the alarms (61% CGM), and do not understand what to do with device information or features (40% pump; 46% CGM). Clinicians wanted lower cost and better insurance coverage for their patients, and they recommended counseling and education to help address barriers and improve adherence to devices.CONCLUSION: Clinicians perceive many barriers to their patients initiating and adhering to diabetes devices. Findings highlight opportunities for intervention to improve clinician-patient communication around device barriers to help address them.