Who Should Access Closed-Loop Technology? A Qualitative Study of Clinician Attitudes in England

Farrington, Conor, Hovorka, Roman and Murphy, Helen R (2020) Who Should Access Closed-Loop Technology? A Qualitative Study of Clinician Attitudes in England. Diabetes Technology & Therapeutics, 22 (5). pp. 404-410. ISSN 1520-9156

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Abstract

Background: Clinicians mediate access to closed-loop technology for people with diabetes. Consequently, their attitudes regarding appropriate levels of closed-loop usage will play a key role in future adoption processes. This study aimed to explore clinician attitudes toward future mainstream closed-loop usage in England. Materials and Methods: We conducted 36 semistructured interviews with clinicians from a range of professional backgrounds working in outpatient clinics in England. Interview topics included clinicians' views on future pathways for closed-loop use and attitudes toward the predictability of users' technology experiences, a key factor in eligibility decision making. We analyzed transcripts using thematic and framework approaches. Results: Clinicians exhibited a range of opinions regarding future eligibility for closed-loop technology. We identified three key strands of clinician opinion, envisaging (1) tighter access for closed loop (n = 10), citing funding challenges and issues arising from user overconfidence or negative technology attitudes; (2) similar access to closed loop as for current diabetes technologies (n = 15), on the grounds that future funding and access pathways will be similar to current arrangements; and (3) wider access for closed-loop technologies (n = 9), given the potential for significant and widespread benefits arising from closed-loop usage, including downstream cost savings alongside improved glycemic control. Conclusions: Clinicians expressed a range of opinions encompassing continuity with current diabetes technologies, while others envisaged either tighter or more liberal access for closed-loop systems. To optimize technology adoption and equitable uptake, future implementation pathways should consider clinician attitudes toward technology use and access.

Item Type: Article
Uncontrolled Keywords: care,closed-loop systems,continuous glucose monitoring,insulin pumps,professionals,systems,type 1 diabetes
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Related URLs:
Depositing User: LivePure Connector
Date Deposited: 29 Feb 2020 08:36
Last Modified: 11 Jul 2020 23:56
URI: https://ueaeprints.uea.ac.uk/id/eprint/74349
DOI: 10.1089/dia.2019.0380

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