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
Year: 2020
Type: article
Abstract: 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 health professionals supporting closed-loop users in routine care will need comprehensive technology training and standardized clinical guidance. Conclusion: These findings constitute an important starting point for the development of formal guidance to support the rollout of closed-loop technology. Our recommendations, if actioned, will help limit the potential additional burden of introducing closed-loop systems in routine clinical care and help inform appropriate user education and support.
Institutions: University of Cambridge, Wellcome/MRC Institute of Metabolic Science, Cambridge Clinical Trials Unit, University of Edinburgh, Leeds Teaching Hospitals NHS Trust, Alder Hey Children's NHS Foundation Trust, John Radcliffe Hospital, University of Oxford, NIHR Oxford Biomedical Research Centre, Southampton Children's Hospital
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Funders: Eli Lilly and Company, Leona M. and Harry B. Helmsley Charitable Trust, Wellcome Trust, Dexcom, National Institute for Health and Care Research, Department of Health and Social Care, Cambridge University Hospitals, Novo Nordisk, Abbott Diabetes Care, Medical Research Council, NIHR Cambridge Biomedical Research Centre, NIHR Evaluation Trials and Studies Coordinating Centre
OpenAlex ID: W3005585385