Who Should Access Closed-Loop Technology? A Qualitative Study of Clinician Attitudes in England
Year: 2020
Type: article
Abstract: Background: Clinicians mediate access to closed-loop technology for people with diabetes. Consequently, their attitudes regarding appropriate levels of closed-loop usage will play a key role in future adoption processes. This study aimed to explore clinician attitudes toward future mainstream closed-loop usage in England. Materials and Methods: We conducted 36 semistructured interviews with clinicians from a range of professional backgrounds working in outpatient clinics in England. Interview topics included clinicians' views on future pathways for closed-loop use and attitudes toward the predictability of users' technology experiences, a key factor in eligibility decision making. We analyzed transcripts using thematic and framework approaches. Results: Clinicians exhibited a range of opinions regarding future eligibility for closed-loop technology. We identified three key strands of clinician opinion, envisaging (1) tighter access for closed loop ( n = 10), citing funding challenges and issues arising from user overconfidence or negative technology attitudes; (2) similar access to closed loop as for current diabetes technologies ( n = 15), on the grounds that future funding and access pathways will be similar to current arrangements; and (3) wider access for closed-loop technologies ( n = 9), given the potential for significant and widespread benefits arising from closed-loop usage, including downstream cost savings alongside improved glycemic control. Conclusions: Clinicians expressed a range of opinions encompassing continuity with current diabetes technologies, while others envisaged either tighter or more liberal access for closed-loop systems. To optimize technology adoption and equitable uptake, future implementation pathways should consider clinician attitudes toward technology use and access.
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Funders: Leona M. and Harry B. Helmsley Charitable Trust, Wellcome Trust, National Institute for Health and Care Research, European Commission, Cambridge University Hospitals, Tommy's, Efficacy and Mechanism Evaluation Programme, NIHR Cambridge Biomedical Research Centre, NIHR Evaluation Trials and Studies Coordinating Centre
Awards: G2018687014, G2166940007, G434337789, G461391184, Institute of Metabolic Science., G4903748289, New technologies to improve glucose control and infant outcomes in pregnant women with type 1 diabetes, G5120548921, G5246447471, G6525891988, G7472242852, Evaluation of the biomedical and psychosocial impact of automated Complete-Loop (Artificial Pancreas) insulin delivery in women with type 1 diabetes during pregnancy, Effect of closed loop insulin delivery from onset of diabetes in youth on progression of type 1 diabetes, G8585681489, G8589133502, The artificial pancreas in children aged 1 to 7 years with type 1 diabetes
OpenAlex ID: W3000498928