Rollout of Closed-Loop Technology to Pregnant Women with Type 1 Diabetes: Healthcare Professionals' Views About Potential Challenges and Solutions

被引：17

作者：

Rankin, David ^{[1
]}

Hart, Ruth I. ^{[1
]}

Kimbell, Barbara ^{[1
]}

Barnard-Kelly, Katharine ^{[2
]}

Brackenridge, Anna ^{[3
]}

Byrne, Caroline ^{[4
]}

Collett, Corinne ^{[5
]}

Dover, Anna R. ^{[6
]}

Hartnell, Sara ^{[4
]}

Hunt, Katharine F. ^{[7
]}

Lee, Tara T. M. ^{[8
,9
]}

Lindsay, Robert S. ^{[10
]}

McCance, David R. ^{[11
]}

McKelvey, Alastair ^{[9
]}

Rayman, Gerry ^{[12
]}

Reynolds, Rebecca M. ^{[6
,13
]}

Scott, Eleanor M. ^{[14
]}

White, Sara L. ^{[3
,15
]}

Hovorka, Roman ^{[16
,17
]}

Murphy, Helen R. ^{[4
,8
,9
]}

Lawton, Julia ^{[1
]}

iDAPT Collaborative Grp

机构：

[1] Univ Edinburgh, Usher Inst, Med Sch, Edinburgh, Scotland

[2] Moor Green Hosp, R&D, Southampton, England

[3] Guys & St Thomas NHS Fdn Trust, Dept Diabet & Endocrinol, London, England

[4] NHS Fdn Trust, Cambridge Univ Hosp, Cambridge, England

[5] Univ East Anglia, Norwich Med Sch, Norwich Clin Trials Unit, Norwich, England

[6] Royal Infirm Edinburgh NHS Trust, Edinburgh Ctr Endocrinol & Diabet, Edinburgh, Scotland

[7] NHS Fdn Trust, Weston Educ Ctr, Diabet Res Off, Kings Coll Hosp, London, England

[8] Univ East Anglia, Norwich Med Sch, Norwich, England

[9] NHS Fdn Trust, Norfolk & Norwich Univ Hosp, Norwich, England

[10] Univ Glasgow, Inst Cardiovasc & Med Sci, Med Sch, Glasgow EH8 9AG, Scotland

[11] Royal Victoria Hosp Belfast, Reg Ctr Endocrinol & Diabet, Belfast, North Ireland

[12] Ipswich Hosp, East Suffolk & North Essex Fdn Trust, Diabet Ctr, Ipswich, England

[13] Univ Edinburgh, Ctr Cardiovasc Sci, Edinburgh, Scotland

[14] Univ Leeds, Leeds Inst Cardiovasc & Metab Med, Leeds, England

[15] Kings Coll London, Dept Women & Childrens Hlth, London, England

[16] Univ Cambridge, MRC Inst Metab Sci, Wellcome Trust, Cambridge, England

[17] Univ Cambridge, Dept Paediat, Cambridge, England

来源：

DIABETES TECHNOLOGY & THERAPEUTICS | 2023年 / 25卷 / 04期

基金：

英国医学研究理事会; 英国惠康基金;

关键词：

Type; 1; diabetes; Closed-loop system; Continuous glucose monitoring; Pregnancy; Healthcare professional; Qualitative research; INSULIN PUMP THERAPY;

D O I：

10.1089/dia.2022.0479

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims: To explore healthcare professionals' views about the training and support needed to rollout closed-loop technology to pregnant women with type 1 diabetes.Methods: We interviewed (n = 19) healthcare professionals who supported pregnant women using CamAPS FX closed-loop during the Automated insulin Delivery Amongst Pregnant women with Type 1 diabetes (AiDAPT) trial. Data were analyzed descriptively. An online workshop involving (n = 15) trial team members was used to inform recommendations. Ethics approvals were obtained in conjunction with those for the wider trial.Results: Interviewees expressed enthusiasm for a national rollout of closed-loop, but anticipated various challenges, some specific to use during pregnancy. These included variations in insulin pump and continuous glucose monitoring expertise and difficulties embedding and retaining key skills, due to the relatively small numbers of pregnant women using closed-loop. Inexperienced staff also highlighted difficulties interpreting data downloads. To support rollout, interviewees recommended providing expert initial advice training, delivered by device manufacturers together with online training resources and specific checklists for different systems. They also highlighted a need for 24 h technical support, especially when supporting technology naive women after first transitioning onto closed-loop in early pregnancy. They further recommended providing case-based meetings and mentorship for inexperienced colleagues, including support interpreting data downloads. Interviewees were optimistic that if healthcare professionals received training and support, their long-term workloads could be reduced because closed-loop lessened women's need for glycemic management input, especially in later pregnancy.Conclusions: Interviewees identified challenges and opportunities to rolling-out closed-loop and provided practical suggestions to upskill inexperienced staff supporting pregnant women using closed-loop. A key priority will be to determine how best to develop mentorship services to support inexperienced staff delivering closed-loop.Clinical Trials Registration: NCT04938557.

引用

页码：260 / 269

页数：10

共 34 条

[1] 15. Management of Diabetes in Pregnancy: Standards of Medical Care in Diabetes-2022 [J].