Human Factors and Data Logging Processes With the Use of Advanced Technology for Adults With Type 1 Diabetes: Systematic Integrative Review (Preprint)

Abstract

Background: People with T1DM are confronted with self-management tasks and strategies to reduce risks of long-term complications against the risk of hypoglycemic events. The potential of advanced and evolving technology to address these issues involves consideration of psychological and behavioral constructs alongside the usability of devices. Access and uptake of advanced technology is further influenced by economic factors and health care provider capacity to support such interventions. Previous reviews have focused upon either clinical outcomes or descriptively scoped the literature and sometimes synthesize studies on adults with children and young people where human factors are different. Objective:The objective of this review was to describe the relationship between human factors and adherence with technology for data logging processes in adults with T1DM and to explore the factors which influence this association. Methods: A systematic literature review.Results: 18 studies were included in the review following a literature search using the PRISMA guidelines and the quality appraisal process. Six constructs emerged from the data analysis:. The relationship between adherence to data logging and measurable outcomes; Satisfaction with the transition to advanced technology for self-management; Use of advanced technology and time spent on diabetes related activities; Strategies to mediate the complexities of diabetes and the use of advanced technology; Cognition in the wild and Meanings, views and perspectives from the users of technology.There was evidence of increased treatment satisfaction on transition to advanced technology (insulin pump and CGM), the most significant contributing factor was when BG levels were consistently < 7.00mmol/l (P =.009). However, participants spent considerable time on their diabetes self-care. There was evidence that 1 logging of data was positively correlated with increasing age with the use of an app that provided meaningful feedback (regression coefficient = 55.8 recordings/ year; P = 0.009). Furthermore, there were benefits of CGM for older people in mediating complexities and their fears of hypoglycemia with reported significant differences in well-being (P= .009).Qualitative studies within the review aimed to explore the use and uptake of technology within the context of everyday lives. There were 'frustrations' with CGM, CSII, calibration of devices and alarms. In addition, the implications of 'body image' and the way in which 'significant' others impacted on the behavior and attitude of the individual towards technology use. There were wide variations in the normal use of and interaction with technology across a continuum of sociocultural contexts. This has implications for the way in which future technologies are designed. Conclusions:Many of the quantitative studies in the review were limited by small sample sizes. This may make it difficult to generalize findings to other contexts. This is further limited by a sample that was predominantly Caucasian, well-contr...