Abstract
Background and Aims
Devices which passively record insulin dose information have the potential to improve diabetes management over active methods of data collection (e.g. logbooks). This simulation study was conducted to understand how healthcare provider (HCP) access to passive insulin data influences prescribing and treatment confidence.
Methods
Multidisciplinary HCPs completed an online survey consisting of hypothetical insulin-injecting patient vignettes. “Patients” were created using a fractional factorial design from a set of real-world, clinical variables (e.g. HbA1c) and presented with a range of data collection methods. HCPs adjusted diabetes treatment and rated their level of confidence in each decision.
Results
Participants (n=208) were endocrinologists (40%), primary care physicians (40%) and diabetes educators (20%). Access to blood glucose, insulin adherence, and insulin dose data were rated most important for diabetes management. HCPs report that ~37% of patients do not log insulin dose information. HCPs considered passive insulin dose capture more trustworthy than other methods of collecting insulin dose data (p<0.05). Treatment confidence did not differ between data collection methods in simulation, however 88% of HCPs rated passive insulin data as being ‘useful’ or ‘extremely useful’. The most common concern regarding absence of insulin dose data was fear of incorrect adjustment (32% of HCPs). Insulin dose decreases correlated with presence of hypoglycemia and insulin logbook incompleteness.
Conclusions
HCPs were more likely to decrease insulin doses if insulin logbooks were not complete. In simulation, access to passive insulin dose data did not increase HCP treatment confidence, however passive insulin data was considered useful and more trustworthy than other data sources.
