Enhancing resources for healthcare professionals caring for people on intensive insulin therapy: Summary from a national workshop

Levine, Brian J.; Close, Kelly L.; Dalton, Deniz; Lackner, Johanna B.; Marathe, Payal H.; McDermott, James; Stang, Ben; TumSuden, Kady; Yovic, Sydney; Maahs, David M.; Oser, Sean M.

doi:10.1016/j.diabres.2020.108169

Cited by 5 publications

(6 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is no universal role differentiation between diabetes providers, diabetes educators, and other members of the healthcare team with AID systems, as every practice environment is different. All clinicians should be aware of how AID systems work ( 104 ) and could benefit from brief training videos, webinars, demonstration devices, step-by-step tools, and device simulation apps ( 102 , 113 ). Additionally, practices or regions should consider the role of “Diabetes Technology Specialists” to provide more specific troubleshooting and device optimization strategies to support other clinicians and PwD.…”

Section: Education Training and Supportmentioning

confidence: 99%

Consensus Recommendations for the Use of Automated Insulin Delivery Technologies in Clinical Practice

et al. 2022

View full text Add to dashboard Cite

The significant and growing global prevalence of diabetes continues to challenge people with diabetes (PwD), healthcare providers and payers. While maintaining near-normal glucose levels has been shown to prevent or delay the progression of the long-term complications of diabetes, a significant proportion of PwD are not attaining their glycemic goals. During the past six years, we have seen tremendous advances in automated insulin delivery (AID) technologies. Numerous randomized controlled trials and real-world studies have shown that the use of AID systems is safe and effective in helping PwD achieve their long-term glycemic goals while reducing hypoglycemia risk. Thus, AID systems have recently become an integral part of diabetes management. However, recommendations for using AID systems in clinical settings have been lacking. Such guided recommendations are critical for AID success and acceptance. All clinicians working with PwD need to become familiar with the available systems in order to eliminate disparities in diabetes quality of care. This report provides much-needed guidance for clinicians who are interested in utilizing AIDs and presents a comprehensive listing of the evidence payers should consider when determining eligibility criteria for AID insurance coverage.

show abstract

Section: Education Training and Supportmentioning

confidence: 99%

Consensus Recommendations for the Use of Automated Insulin Delivery Technologies in Clinical Practice

et al. 2022

View full text Add to dashboard Cite

show abstract

“…The latter was not used by the majority of clinicians, who reported having their own EHR templates and methods of documentation. However, true EHR integration (beyond template text that requires cutting and pasting) has been identified as a major request from clinicians to incorporate and streamline tools into their workflow 8,17 and was also suggested by the participants of this study to improve the Control-IQ Tool.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a New Clinical Tool to Enhance Clinical Care of Control-IQ Users

Messer

Berget

Centi

et al. 2022

J Diabetes Sci Technol

View full text Add to dashboard Cite

Background: The purpose of this study was to develop and test a new Clinic Tool to assist health care professionals with clinical care of persons with diabetes using the Control-IQ system. Methods: A Clinic Tool was iteratively developed with input from diabetes clinicians, which outlined a systematic process for assessing data, reviewing insulin settings, providing education, and documenting the encounter. Diabetes clinicians were recruited to trial the Clinical Tool in up to five clinical encounters (in-person, telehealth, or telephone). Quantitative surveys and free-text responses, including a knowledge quiz and the System Usability Scale (SUS), were administered to determine clinician satisfaction, confidence, knowledge, and implications for practice. Results: Twenty-nine clinicians (43% endocrinologists, mean 10.7 years in practice) enrolled in the study and completed 89 encounters using the Control-IQ Clinic Tool. Participants spent an average of 10 minutes using the Tool and reported excellent SUS scores within the 90%-95% percentile for usability. Knowledge quiz scores increased in 42% of participants. Both familiarity with Control-IQ and confidence providing clinical care to Control-IQ users significantly improved ( P = .009 and P < .001 respectively). Ninety percent of participants agreed that the Tool will change their clinical care going forward. Conclusion: The Control-IQ Clinical Tool is highly usable and impacted clinical care delivery to Control-IQ users. Tools that serve to improve clinician confidence in delivery of care to diabetes device users should be expanded, leveraged, and studied to assess the impact on adherence and glycemic control for persons with diabetes.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Lack of knowledge of diabetes devices is a barrier to providing care for HCL users, with one survey indicating 74% of clinicians having concerns about being able to answer user questions about devices 17 . Practical, timely resources for on diabetes technology that can be incorporate into a clinical workflow are lacking, 28 and the HCLClinical Tool was unique in its function.We have made a version of this tool available for free use and distribution on our PANTHER (Practical AdvaNced THERapies for Diabetes) Program website, http://BDCPantherDiabetes.org.…”

Section: Discussionmentioning

confidence: 99%

Initiating hybrid closed loop: A program evaluation of an educator‐led Control‐IQ follow‐up at a large pediatric clinic

et al. 2021

View full text Add to dashboard Cite

Background: Control-IQ (Tandem Diabetes) is a hybrid closed-loop (HCL) system that users self-initiate after completing online training. Best practices for clinical followup are not known. Our quality improvement objective was to evaluate the usefulness of an educator-led follow-up program for new HCL users in a type 1 diabetes pediatric clinic.Methods: We implemented an ''HCLCheck-in'' program, first determining when users started HCL, then having diabetes educators contact them for a follow-up call 2-weeks after start. Educators used a Clinical Tool to inform insulin dose and behavior recommendations, and used four benchmarks to determine need for further follow-up: ≥71% HCL use, ≥71% CGM use, ≥60% Time-in-Range (TIR, 70-180 mg/ dL), <5% below 70 mg/dL. Family and educator satisfaction were surveyed.Results: One-hundred-twenty-three youth [mean age 13.6 ± 3.7 y, 53.7% female, mean HbA1c 7.6 ± 1.4% (60 mmol/mol)] completed an HCLCheck-in call a median (IQR) of 18(15, 21) days post-HCL start. 74 users (60%) surpassed benchmarks with 94% HCL use and 71% TIR. Of the 49 who did not, 16 completed a second call, and improved median TIR 12.5% (p = 0.03). HCL users reported high satisfaction with the program overall [median 10 (9, 10) out of 10]. Educators spent a median of 45 (32,70) minutes per user and rated satisfaction with the program as 8 (7,9.5) and the Tool as 9 (9, 10). Conclusion:Our HCLCheck-in program received high satisfaction ratings and resulted in improved TIR for those initially not meeting benchmarks, suggesting users may benefit from early follow-up. Similar programs may be beneficial for other new technologies. K E Y W O R D S hybrid closed loop, pediatrics, program evaluation, quality improvement, type 1 diabetes 1 | INTRODUCTION Diabetes technology options have greatly increased for persons with type 1 diabetes (PWD) in the past decade, with the commercialization of multiple advanced insulin pumps, including hybrid closed-loop (HCL) systems. 1 HCL systems consist of an insulin pump, a connected continuous glucose monitor (CGM), and an algorithm to increase or decrease insulin delivery in response to glucose levels. The most recently available hybrid closed loop system, the t:slim X2 with Control-IQ technology (''Control-IQ'', Tandem Diabetes), was commercially approved in the United States in January 2020 for PWD ages 14 and over and has since been approved for PWD ages 6 and

show abstract

Enhancing resources for healthcare professionals caring for people on intensive insulin therapy: Summary from a national workshop

Cited by 5 publications

References 20 publications

Consensus Recommendations for the Use of Automated Insulin Delivery Technologies in Clinical Practice

Consensus Recommendations for the Use of Automated Insulin Delivery Technologies in Clinical Practice

Evaluation of a New Clinical Tool to Enhance Clinical Care of Control-IQ Users

Initiating hybrid closed loop: A program evaluation of an educator‐led Control‐IQ follow‐up at a large pediatric clinic

Contact Info

Product

Resources

About