SAN DIEGO — Diabetes providers’ comfort with diabetes technology and beliefs about their patients’ comfort greatly influence the adoption of continuous glucose monitoring, according to a speaker here.
“Adoption of [CGM] technology is low compared to insulin pumps and hasn’t been as rapidly adopted as was forecast years ago,” Molly L. Tanenbaum, PhD, a postdoctoral psychology fellow at Stanford University School of Medicine, said during a presentation. “We know that CGM has benefits like increased time in target range, decreased hypoglycemia and improved quality of life.”
To better understand the role of providers in increasing adoption and preventing discontinuation of diabetes technology, Tanenbaum and colleagues surveyed 209 clinicians who treat patients with diabetes: 47% were nurses, 22% were dietitians, 15% were endocrinologists and 60% were also certified diabetes educators; 92% were women, 59% were older than 49 years and mean time in practice was 14 years. Providers were asked about their comfort with technology and whether they had time to keep up with changes in technology and to help patients in clinic with devices and data, for example. The researchers used K-means clustering analysis to generate three provider profiles in respect to diabetes technology.
The researchers described 39% of those surveyed as not yet ready to encourage their patients to adopt CGM. This group was less likely than other providers to believe that CGM would benefit their patients. They reported having too little time to use CGM data with their patients in clinic. This group also reported difficulty keeping up with new technology. Only 18% of their patients used CGM, most of their patients had type 2 diabetes, and they were more likely to be adult providers than pediatric providers.
Twenty percent of those surveyed indicated they were ready to adopt new diabetes technology and believed CGM use is beneficial for patients. They reported having enough time to help patients with technology and review data. About 33% of their patients used CGM; they had the highest proportion of patients with type 1 diabetes and their patient mix was more likely to be pediatric than adult providers.
The other 41% of survey respondents were designated as “cautious” about adopting diabetes technology. About 30% of their patients were using CGM. They treated both type 1 and type 2 diabetes and adults as well as children.
“What stood out about this group was that their main obstacle was thinking that their patients have many barriers to using CGM,” Tanenbaum said. “If they had ways to overcome these barriers, we could potentially see a change in CGM uptake rates.”
These providers reported that patients would be nervous about relying on technology, that patients did not like to wear devices and feared the devices would not work correctly.
“While we work to address patient barriers, and feel like we have the tools to work through those with patients, we want to make sure that we can align clinicians and patients so that we’re on the same page about what the barriers are and work together on those,” Tanenbaum said. – by Jill Rollet
Tanenbaum ML, et al. 64-OR. Presented at: American Diabetes Association 77th Scientific Sessions; June 9-13, 2017; San Diego.
Disclosures: The researchers report no relevant financial disclosures.