Continuous glucose monitoring among nurse practitioners in primary care: Characteristics associated with prescribing and resources needed to support use.

IF 1.2 4区 医学
Tristen L Hall, L Miriam Dickinson, Meredith K Warman, Tamara K Oser, Sean M Oser
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引用次数: 0

Abstract

Background: Continuous glucose monitoring (CGM) can improve health for people with diabetes but is limited in primary care (PC). Nurse Practitioners (NPs) in PC can improve diabetes management through CGM, but NPs' interest in CGM and support needed are unclear.

Purpose: We describe behaviors and attitudes related to CGM for diabetes management among NPs in PC.

Methodology: This cross-sectional web-based survey of NPs practicing in PC settings used descriptive statistics to describe CGM experience and identify resources to support prescribing. We used multivariable regression to explore characteristics predicting prescribing and confidence using CGM for diabetes.

Results: Nurse practitioners in hospital-owned settings were twice as likely to have prescribed CGM (odds ratio [OR] = 2.320, 95% CI [1.097, 4.903]; p = .002) than private practice; those in academic medical centers were less likely (OR = 0.098, 95% CI [0.012, 0.799]; p = .002). Past prescribing was associated with favorability toward future prescribing (coef. = 0.7284, SE = 0.1255, p < .001) and confidence using CGM to manage diabetes (type 1: coef. = 3.57, SE = 0.51, p < .001; type 2: coef. = 3.49, SE = 0.51, p < .001). Resources to prescribe CGM included consultation with an endocrinologist (62%), educational website (61%), and endocrinological e-consultations (59%).

Conclusions: Nurse practitioners are open to prescribing CGM and can improve diabetes management and health outcomes for PC patients.

Implications: Research should explore mechanisms behind associations with CGM experience and attitudes. Efforts to advance CGM should include educational websites and endocrinology consultations for NPs in PC.

基层医疗机构执业护士的连续血糖监测:与开具处方相关的特征以及支持使用处方所需的资源。
背景:连续血糖监测(CGM)可改善糖尿病患者的健康状况,但在初级保健(PC)中的应用有限。PC领域的执业护士(NPs)可通过CGM改善糖尿病管理,但NPs对CGM的兴趣和所需支持尚不明确。目的:我们描述了PC领域的NPs对CGM用于糖尿病管理的行为和态度:这项针对在 PC 环境中执业的 NP 的横断面网络调查使用描述性统计来描述 CGM 经验并确定支持处方的资源。我们使用多元回归法来探索预测糖尿病 CGM 处方和使用信心的特征:结果:与私人诊所相比,医院所有机构的执业护士开具 CGM 处方的可能性是私人诊所的两倍(几率比 [OR] = 2.320,95% CI [1.097,4.903];p = .002);学术医疗中心的执业护士开具 CGM 处方的可能性较低(OR = 0.098,95% CI [0.012,0.799];p = .002)。过去开具处方与未来开具处方的可能性相关(系数 = 0.7284,SE = 0.1255,p < .001),也与使用 CGM 控制糖尿病的信心相关(1 型:系数 = 3.57,SE = 0.51,p < .001;2 型:系数 = 3.49,SE = 0.51,p < .001)。开具 CGM 处方的资源包括咨询内分泌科医生(62%)、教育网站(61%)和内分泌科电子咨询(59%):结论:护士开具 CGM 处方是开放的,可以改善 PC 患者的糖尿病管理和健康状况:研究应探索 CGM 经验和态度背后的关联机制。推进 CGM 的工作应包括为 PC 领域的 NP 提供教育网站和内分泌咨询。
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来源期刊
自引率
16.70%
发文量
172
期刊介绍: The Journal of the American Association of Nurse Practitioners (JAANP) is a monthly peer-reviewed professional journal that serves as the official publication of the American Association of Nurse Practitioners. Published since 1989, the JAANP provides a strong clinical focus with articles related to primary, secondary, and tertiary care, nurse practitioner education, health policy, ethics and ethical issues, and health care delivery. The journal publishes original research, integrative/comprehensive reviews, case studies, a variety of topics in clinical practice, and theory-based articles related to patient and professional education. Although the majority of nurse practitioners function in primary care, there is an increasing focus on the provision of care across all types of systems from acute to long-term care settings.
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