Determinants of implementation of continuous glucose monitoring for patients with Insulin-Treated type 2 diabetes: a national survey of primary care providers.

IF 2 Q2 MEDICINE, GENERAL & INTERNAL
Varsha G Vimalananda, Ben Kragen, Alison J Leibowitz, Shirley Qian, Jolie Wormwood, Amy M Linsky, Patricia Underwood, Paul R Conlin, Bo Kim
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Abstract

Objectives: To identify determinants of continuous glucose monitoring (CGM) implementation from primary care providers' (PCPs') perspectives and examine the associations of these determinants with both PCP intent to discuss CGM with eligible patients and facility-level uptake of CGM.

Study design: Cross-sectional survey.

Methods: A survey about CGM implementation for patients with type 2 diabetes on insulin was distributed to all PCPs in the Department of Veterans Affairs (VA) health system from October 2023-April 2024. Multi-item scales measured perceived clinical benefits of CGM, workload capacity, knowledge about CGM, access to CGM resources, and support from leadership and other services. Responses were on a 5-point Likert scale from "Strongly Disagree" to "Strongly Agree". An item asked about likelihood of initiating discussions about starting CGM. Facility-level uptake was measured using VA administrative data. Multivariable regression models assessed the relationship between determinants of CGM implementation and both PCP intent to discuss CGM and facility-level uptake.

Results: Of 1373 respondents, most perceived clinical benefits of CGM (79% "Agree" + "Strongly Agree"). Very few indicated sufficient access to resources (8%) and support from leadership & other services (5%). After adjustment for respondent characteristics, the scale most strongly associated with PCP intent to discuss CGM was PCP Knowledge About CGM (B = 0.54, P <.001). Facility uptake of CGM was associated with Clinical Benefits of CGM (B = 0.10, P =.026) and Support from Leadership & Other Services (B = 0.18, P <.001).

Conclusions: PCPs perceive benefits to CGM but lack sufficient knowledge, resources, and workload capacity to manage it alone. PCP education about CGM use and interprofessional support for uptake may increase the likelihood that eligible patients use CGM.

对胰岛素治疗的2型糖尿病患者实施持续血糖监测的决定因素:一项全国初级保健提供者调查。
目的:从初级保健提供者(PCP)的角度确定持续血糖监测(CGM)实施的决定因素,并检查这些决定因素与PCP意图与合格患者讨论CGM和设施水平CGM的相关性。研究设计:横断面调查。方法:对2023年10月~ 2024年4月在美国退伍军人事务部(VA)卫生系统所有pcp中使用胰岛素治疗的2型糖尿病患者的CGM实施情况进行调查。多条目量表测量了认知CGM的临床效益、工作量能力、CGM知识、获得CGM资源以及来自领导和其他服务的支持。回答是5分李克特量表,从“非常不同意”到“非常同意”。有一个项目询问是否有可能发起关于开展CGM的讨论。使用VA管理数据测量设施级别的吸收情况。多变量回归模型评估了CGM实施的决定因素与PCP讨论CGM和设施水平摄取的意图之间的关系。结果:在1373名受访者中,大多数人认为CGM的临床益处(79%“同意”+“强烈同意”)。很少有人表示有足够的资源(8%)和来自领导和其他服务的支持(5%)。在调整受访者特征后,与PCP讨论CGM意图最密切相关的量表是PCP关于CGM的知识(B = 0.54, P)。结论:PCP意识到CGM的好处,但缺乏足够的知识、资源和工作量能力来单独管理CGM。PCP关于CGM使用和跨专业支持的教育可能会增加符合条件的患者使用CGM的可能性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
4.40
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