Health professionals' views about who would benefit from using a closed-loop system: a qualitative study.
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Authors
Kimbell, B
Ashcroft, NL
Varghese, L
Allen, JM
Campbell, F
Randell, T
Besser, REJ
Trevelyan, N
CLOuD Consortium,
Publication Date
2020-06Journal Title
Diabetic medicine : a journal of the British Diabetic Association
ISSN
0742-3071
Publisher
Wiley-Blackwell
Volume
37
Issue
6
Pages
1030-1037
Language
eng
Type
Article
This Version
AM
Physical Medium
Print-Electronic
Metadata
Show full item recordCitation
Lawton, J., Kimbell, B., Rankin, D., Ashcroft, N., Varghese, L., Allen, J., Boughton, C., et al. (2020). Health professionals' views about who would benefit from using a closed-loop system: a qualitative study.. Diabetic medicine : a journal of the British Diabetic Association, 37 (6), 1030-1037. https://doi.org/10.1111/dme.14252
Abstract
Aims
To explore health professionals’ views about who would benefit from using a closed-loop system and who should be prioritised for access to the technology in routine clinical care.
Methods
Health professionals (n=22) delivering the Closed Loop from Onset in type 1 Diabetes (CLOuD) trial were interviewed after they had ≥6 months experience supporting participants using a closed-loop system. Data were analysed thematically.
Results
Interviewees described holding strong assumptions about the kinds of people who would use the technology effectively prior to the trial. Interviewees described changing their views as a result of observing individuals engaging with the closed-loop system in ways they had not anticipated. This included educated, technologically competent individuals who over-interacted with the system in ways which could compromise glycaemic control. Other individuals, who health professionals assumed would struggle to understand and use the technology, were reported to have benefited from it because they stood back and allowed the system to operate without interference. Interviewees concluded that individual, family, and psychological attributes cannot be used as pre-selection criteria and, ideally, all individuals should be given the chance to try the technology. However, it was recognised that clinical guidelines will be needed to inform difficult decisions about treatment allocation (and withdrawal), with young children and infants being considered priority groups.
Conclusions
To ensure fair and equitable access to closed-loop systems, prejudicial and stereotypical assumptions held by health professionals may need to be addressed. To support their decision-making, clinical guidelines need to be made available in a timely manner.
Keywords
CLOuD Consortium
Sponsorship
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)
Helmsley Charitable Trust (#2016PG-T1D045)
Department of Health (via National Institute for Health Research (NIHR)) (EME 14/23/09)
Wellcome Trust (100574/Z/12/Z)
Embargo Lift Date
2021-01-27
Identifiers
External DOI: https://doi.org/10.1111/dme.14252
This record's URL: https://www.repository.cam.ac.uk/handle/1810/300236
Rights
All rights reserved