Continuous Glucose Monitoring in Primary Care: Understanding and Supporting Clinicians' Use to Enhance Diabetes Care.

Autor: Oser TK; University of Colorado Department of Family Medicine, Aurora, Colorado., Hall TL; University of Colorado Department of Family Medicine, Aurora, Colorado Tristen.Hall@CUAnschutz.edu., Dickinson LM; University of Colorado Department of Family Medicine, Aurora, Colorado., Callen E; American Academy of Family Physicians, Leawood, Kansas., Carroll JK; University of Colorado Department of Family Medicine, Aurora, Colorado.; American Academy of Family Physicians, Leawood, Kansas., Nease DE Jr; University of Colorado Department of Family Medicine, Aurora, Colorado., Michaels L; Oregon Health and Science University, Portland, Oregon., Oser SM; University of Colorado Department of Family Medicine, Aurora, Colorado.
Jazyk: angličtina
Zdroj: Annals of family medicine [Ann Fam Med] 2022 Nov-Dec; Vol. 20 (6), pp. 541-547.
DOI: 10.1370/afm.2876
Abstrakt: Purpose: Diabetes affects approximately 34 million Americans and many do not achieve glycemic targets. Continuous glucose monitoring (CGM) is associated with improved health outcomes for patients with diabetes. Most adults with diabetes receive care for their diabetes in primary care practices, where uptake of CGM is unclear.
Methods: We used a cross-sectional web-based survey to assess CGM prescribing behaviors and resource needs among primary care clinicians across the United States. We used descriptive statistics and multivariable regression to identify characteristics associated with prescribing behaviors, openness to prescribing CGM, and to understand resources needed to support use of CGM in primary care.
Results: Clinicians located more than 40 miles from the nearest endocrinologist's office were more likely to have prescribed CGM and reported greater likelihood to prescribe CGM in the future than those located within 10 miles of an endocrinologist. Clinicians who served more Medicare patients reported favorable attitudes toward future prescribing and higher confidence using CGM to manage diabetes than clinicians with lower Medicare patient volume. The most-needed resources to support CGM use in primary care were consultation on insurance issues and CGM training.
Conclusions: Primary care clinicians are interested in using CGM for patients with diabetes, but many lack the resources to implement use of this diabetes technology. Use of CGM can be supported with education in the form of workshops and consultation on insurance issues targeted toward residents, recent graduates, and practices without a nearby endocrinologist. Continued expansion of Medicare and Medicaid coverage for CGM can also support CGM use in primary care.
(© 2022 Annals of Family Medicine, Inc.)
Databáze: MEDLINE
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