2410-PUB: Insulin Pumps Accessed through Provincial Funding and Quality of Life: A Qualitative Study

Abstract

The Nova Scotia Insulin Pump Program (NSIPP) subsidizes the cost of insulin pump (CSII) therapy for patients aged 25 and under with type 1 diabetes. Its medical eligibility criteria ensure structured care and follow-up with focused diabetes teams according to provincial guidelines. Studies on CSII and quality of life are mostly survey-based, thus first voice patient experiences are limited. This qualitative study examined patient/parent perspectives on how CSII affects quality of life and is unique in the context of provincial funding. A phenomenological approach was used. In-depth semi-structured telephone interviews averaging 36 minutes were completed with NSIPP enrollees and/or their parents, depending on age. Saturation was reached after 23 interviews. Verbatim transcripts were coded independently by two researchers using NVivo. Analysis began with a discussion of coding discrepancies, which were resolved using concept mapping to clarify relationships between codes and identify main themes. More freedom in daily life, feelings of control over life and diabetes, less worry and more positive intra/interpersonal social experiences were main themes, but how they were expressed depended on the patient’s stage of life. CSII facilitated precise insulin delivery, allowing more freedom in daily activities. This freedom led to feelings of control, less worry and improvements in social life. These outcomes manifested in how common life events were experienced. For example, parents often saw CSII as enabling their teen to gain independence, while young adults focused on CSII supporting them to function at work, school, and in relationships. Finally, NSIPP’s financial help was necessary for those without private insurance and experiences with NSIPP’s defined, structured care and follow-up were positive for all. Overall, NSIPP’s financial support to access CSII therapy and its structured care and follow-up improved quality of life, and the exact ways depended on the patients’ stage of life. Disclosure E.J. Haynes: None. M.N. Ley: None. P.J. Talbot: None. M. Dunbar: None. E.A. Cummings: None. Funding Dalhousie Medical Research Foundation