“It Is Definitely a Game Changer”: A Qualitative Study of Experiences with In-home Overnight Closed-Loop Technology Among Adults with Type 1 Diabetes

Hendrieckx, Christel; Poole, L.; Sharifi, Amin; Jayawardene, Dilshani; Loh, Margaret; Horsburgh, Jodie C.; Bach, Leon A.; Colman, Peter G; Kumareswaran, Kavita; Jenkins, Alicia J.; MacIsaac, Richard J; Ward, Glenn; Grosman, Benyamin; Roy, Anirban; O’Neal, David N

doi:10.1089/dia.2017.0007

Cited by 29 publications

(26 citation statements)

References 15 publications

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“…Established guidelines recommend the use of CGM and its benefits in people with Type 1 diabetes have been demonstrated [2]. Furthermore, a small number of qualitative studies examining people's experiences with CGM are available [3][4][5][6][7][8][9][10][11]. A recent review of qualitative studies that explored the psychosocial impacts of CGM indicated that, in general, responses to the technology are positive [12].…”

Section: Introductionmentioning

confidence: 99%

Use of remote monitoring with continuous glucose monitoring in young children with Type 1 diabetes: the parents’ perspective

et al. 2019

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Aim Remote monitoring with continuous glucose monitoring (CGM) in children with Type 1 diabetes mellitus has recently become available, but little is known about caregivers’ experiences of its use, particularly in younger children. The aim of this study was to explore parents’ everyday experiences of using this technology. Methods The parents of children with Type 1 diabetes diagnosed for > 1 year, aged 2–12 years were invited to participate in a semi‐structured interview. Interviews were the second phase of a randomized cross‐over study using standard insulin therapy with or without CGM and remote monitoring for two 3‐month periods. Open‐ended questions were used to explore parents’ real‐life experiences of the remote monitoring and CGM system. Interviews were analysed using thematic analysis. Results Five themes related to remote monitoring emerged: (i) impact on sleep quality for the parents, (ii) peace of mind, (iii) impact on anxiety, (iv) freedom and confidence for the parents and children, and (v) impact on relationships. Furthermore, parents reported on themes related to CGM in general, such as better understanding of how to manage and control their child's diabetes and experiences related to physical or technical aspects. Conclusion Overall, parents of primary school children reported that using remote monitoring and CGM was a mostly beneficial experience. However, negative aspects within the themes were also reported. These findings will help to provide a structure to discuss parent and child expectations and provide targeted education at the start of using remote monitoring and CGM.

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Section: Introductionmentioning

confidence: 99%

Use of remote monitoring with continuous glucose monitoring in young children with Type 1 diabetes: the parents’ perspective

et al. 2019

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“…Benefits include improved daytime [6] and night-time [6,7] glycaemic control, and psychosocial benefits of reduced worry [6] and burden [8,9], decreased fear of hypoglycaemia [9], decreased diabetes distress [8], improved sleep [6], increased treatment satisfaction [8], improved well-being [7], and trust in the system [5,8]. Concerns such as delays in responding to out of range numbers [8,9], algorithms that were too conservative [5], challenges around exercise [5][6][7][8]10], technical difficulties [6,8,10] such as inaccurate sensors or connectivity challenges [10], intrusive alarms [5,6,10] and concerns regarding the size of the devices [6][7][8], and the need to carry multiple devices [5,9] were all raised.…”

Section: Introductionmentioning

confidence: 99%

Assessing patient‐reported outcomes for automated insulin delivery systems: the psychometric properties of the INSPIRE measures

et al. 2019

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Aim Participants in clinical trials assessing automated insulin delivery systems report perceived benefits and burdens that reflect their experiences and may predict their likelihood of uptake and continued use of this novel technology. Despite the importance of understanding their perspectives, there are no available validated and reliable measures assessing the psychosocial aspects of automated insulin delivery systems. The present study assesses the initial psychometric properties of the INSPIRE measures, which were developed for youth and adults with Type 1 diabetes, as well as parents and partners. Methods Data from 292 youth, 159 adults, 150 parents of youth and 149 partners of individuals recruited from the Type 1 Diabetes Exchange Registry were analysed. Participants completed INSPIRE questionnaires and measures of quality of life, fear of hypoglycaemia, diabetes distress, glucose monitoring satisfaction. Exploratory factor analysis assessed factor structures. Associations between INSPIRE scores and other measures, HbA1c, and technology use assessed concurrent and discriminant validity. Results Youth, adult, parent and partner measures assess positive expectancies of automated insulin delivery systems. Measures range from 17 to 22 items and are reliable (α = 0.95–0.97). Youth, adult and parent measures are unidimensional; the partner measure has a two‐factor structure (perceptions of impact on partners versus the person with diabetes). Measures showed concurrent and discriminant validity. Conclusions INSPIRE measures assessing the positive expectancies of automated insulin delivery systems for youth, adults, parents and partners have meaningful factor structures and are internally consistent. The developmentally sensitive INSPIRE measures offer added value as clinical trials test newer systems, systems become commercially available and clinicians initiate using these systems.

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“…To date, most studies have focused on the experiences of people with type 1 diabetes and/or their family members when using closed-loop systems. [3][4][5][6][7][8][9][10][11][12][13] Health professionals' perspectives have only received limited attention, including their views about the training, support, and resourcing needed to support individuals using the technology in routine clinical care. This is an important omission, given the evidence that a key mediating factor in people's access to and experience of using diabetes technologies is professionals being appropriately trained and supported.…”

Section: Introductionmentioning

confidence: 99%

What Training, Support, and Resourcing Do Health Professionals Need to Support People Using a Closed-Loop System? A Qualitative Interview Study with Health Professionals Involved in the Closed Loop from Onset in Type 1 Diabetes (CLOuD) Trial

Kimbell

Rankin

Ashcroft

et al. 2020

Diabetes Technology & Therapeutics

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Background: We explored health professionals' views about the training, support, and resourcing needed to support people using closed-loop technology in routine clinical care to help inform the development of formal guidance. Methods: Interviews were conducted with health professionals (n = 22) delivering the Closed Loop from Onset in Type 1 Diabetes (CLOuD) trial after they had ‡6 months' experience of supporting participants using a closed-loop system. Data were analyzed descriptively. Results: Interviewees described how, compared with other insulin regimens, teaching and supporting individuals to use a closed-loop system could be initially more time-consuming. However, they also noted that after an initial adjustment period, users had less need for initiating contact with the clinical team compared with people using pumps or multiple daily injections. Interviewees highlighted how a lessened need for ad hoc clinical input could result in new challenges; specifically, they had fewer opportunities to reinforce users' diabetes knowledge and skills and detect potential psychosocial problems. They also observed heightened anxiety among some parents due to the constant availability of data and unrealistic expectations about the system's capabilities. Interviewees noted that all local diabetes teams should be empowered to deliver closed-loop system care, but stressed that

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“It Is Definitely a Game Changer”: A Qualitative Study of Experiences with In-home Overnight Closed-Loop Technology Among Adults with Type 1 Diabetes

Cited by 29 publications

References 15 publications

Use of remote monitoring with continuous glucose monitoring in young children with Type 1 diabetes: the parents’ perspective

Use of remote monitoring with continuous glucose monitoring in young children with Type 1 diabetes: the parents’ perspective

Assessing patient‐reported outcomes for automated insulin delivery systems: the psychometric properties of the INSPIRE measures

What Training, Support, and Resourcing Do Health Professionals Need to Support People Using a Closed-Loop System? A Qualitative Interview Study with Health Professionals Involved in the Closed Loop from Onset in Type 1 Diabetes (CLOuD) Trial

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