Discontinued Use of the Loop Insulin Dosing System: A Mixed-Methods Investigation.
Discontinued Use of the Loop Insulin Dosing System: A Mixed-Methods Investigation.
复制标题
循环胰岛素给药系统的停止使用：混合方法调查。
DOI：
10.1089/dia.2021.0362
复制
发表时间：
2022
影响因子：
5.4
通讯作者：
Naranjo,Diana
中科院分区：
文献类型：
--
作者：
Wong,JessieJ;Suttiratana,SakinahC;Lal,RayhanA;Lum,JohnW;Lanning,MonicaS;Dunlap,Adrienne;Arbiter,Brandon;Hanes,SarahJ;Bailey,RyanJ;Hood,KoreyK;Naranjo,Diana
背景：Loop是一个开源的自动化胰岛素给药系统，它允许用户无与伦比地控制影响未来血糖预测的系统设置。方法：在一项大型观察性研究中，874名Loop参与者完成了调查并提供了血糖数据，其中46人(5.3%)自认为在观察期间停止使用Loop，45人完成了停用调查，22人提供了系统设置数据，19人参加了关于他们停止使用Loop的半结构化访谈。定性数据被转录、编码和分析。结果：年龄较大和不信任循环与停止使用有关，尽管没有其他人口统计学或临床特征显著相关。最受认可的理由是“我决定尝试其他方法”(27.8%)，其次是“它并没有像我想象的那样有用”(22.2%)。定性分析显示，突出的主题集中在精神和情感负担以及调整环境上。停止使用Loop的其他原因包括担心糖尿病供应商不同意使用Loop，获得组件设备的障碍，尝试新/不同技术的愿望，担心Loop无法适应特定的运动或低剂量胰岛素治疗，以及担心在怀孕期间使用Loop。人们注意到，通过加强技术援助和专家指导，可以减轻负担。结论：尽管LOOP观察性研究中的大多数人继续使用，但停止使用的人报告了类似的挑战。特定于设置计算的技术支持和教育可以扩大Loop的好处，减轻负担，并支持在新的Loop用户中持续使用。临床试验注册：ClinicalTrials.gov(NCT03838900)。
Background:Loop is an open-source automated insulin dosing system that allows users unrivaled control over system settings that affect future glucose prediction. Thousands use Loop, but little is known about those who discontinue.Methods:In a large observational study, 874 Loop participants completed surveys and provided glycemic data, 46 (5.3%) of those self-identified as discontinuing Loop use during the observation window, 45 completed a discontinued use survey, 22 provided system settings data, and 19 participated in semistructured interviews about their discontinuation. Qualitative data were transcribed, coded, and analyzed.Results:Older age and not trusting Loop were associated with discontinued use, although no other demographic or clinical characteristics were significant correlates. The most endorsed reasons were “I decided to try something else” (27.8%) followed by “It just didn't help as much as I thought it would” (22.2%). Qualitative analyses revealed prominent themes centered upon mental and emotional burden and adjusting settings. Other reasons for discontinued use included fear of disapproval of Loop use from diabetes provider, barriers to acquiring component devices, a desire to try new/different technologies, concerns that Loop could not accommodate specific exercise or low insulin dose regimens, and worry about Loop use during pregnancy. It was noted that burdens might be alleviated by enhanced technical assistance and expert guidance.Conclusions:Although the majority of individuals in the Loop observational study continued use, those who discontinued reported similar challenges. Technical support and education specific to setting calculations could expand Loop benefits, alleviate burden, and support sustained use among new Loop users. Clinical Trial Registration: clinicaltrials.gov (NCT03838900).