Determining the Perception and Willingness of Primary Care Providers to Prescribe Advanced Diabetes Technologies.

IF 1.6 Q3 HEALTH CARE SCIENCES & SERVICES Journal of Patient-Centered Research and Reviews Pub Date : 2021-07-19 eCollection Date: 2021-01-01 DOI:10.17294/2330-0698.1819
Alexander O'Donovan, Sean M Oser, Jessica Parascando, Arthur Berg, Donald E Nease, Tamara K Oser
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引用次数: 3

Abstract

Advanced diabetes technologies have produced increasingly favorable outcomes compared to older treatments. Disparities in practice resources have led to a treatment disparity by clinical setting, where endocrinologists typically prescribe far more such technologies than primary care providers (PCPs). Fully automated artificial pancreas systems (APS), which combine technologies to deliver and adjust insulin dosing continuously in response to automatic and continuous glucose monitoring, may be more straightforward for PCPs to prescribe and manage, therefore extending their benefit to more patients. We aimed to assess willingness of PCPs to prescribe advanced diabetes technologies through a cross-sectional survey of PCPs from 4 geographically diverse centers. While respondents were uncomfortable initiating (63 of 72, 88%) or adjusting (64 of 72, 89%) traditional insulin pumps, their views on APS were quite different: 71 of 76 (93%) saw advantages to prescribing APS by PCPs rather than only endocrinologists. Most would consider prescribing APS for type 1 diabetes (58 of 76, 76%) and type 2 diabetes (52 of 76, 68%). No differences were seen among attendings, residents, or nurse practitioners. APS were much more acceptable than traditional insulin pumps among this primary care sample. If successful, primary care management of closed-loop APS would greatly increase access to such therapies and reduce disparities among those patients who face more difficulty accessing subspecialty care than they do primary care.

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决定初级保健提供者对先进糖尿病技术处方的认知和意愿。
与旧的治疗方法相比,先进的糖尿病技术产生了越来越有利的结果。实践资源的差异导致了临床环境的治疗差异,内分泌学家通常比初级保健提供者(pcp)开出更多的此类技术。全自动人工胰腺系统(APS)结合了各种技术,可以根据自动和连续的血糖监测连续地输送和调整胰岛素剂量,对于pcp来说,这可能更容易处方和管理,从而使更多的患者受益。我们的目的是通过对来自4个地理位置不同中心的pcp进行横断面调查,评估pcp开具先进糖尿病技术的意愿。虽然受访者对启动(72,88%中的63人)或调整(72,89%中的64人)传统胰岛素泵感到不舒服,但他们对APS的看法却大不相同:76人中有71人(93%)认为由pcp而不是仅由内分泌学家开处方APS有好处。大多数人会考虑为1型糖尿病(76人中的58人,76%)和2型糖尿病(76人中的52人,68%)开APS。在主治医师、住院医师和执业护士之间没有发现差异。在这个初级保健样本中,APS比传统胰岛素泵更容易接受。如果成功的话,闭环APS的初级保健管理将大大增加此类治疗的可及性,并减少那些更难获得亚专科护理的患者之间的差异。
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来源期刊
Journal of Patient-Centered Research and Reviews
Journal of Patient-Centered Research and Reviews HEALTH CARE SCIENCES & SERVICES-
自引率
5.90%
发文量
35
审稿时长
20 weeks
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