How Specific Features May Shape the Shared-Decision Making Process Involved in Clinicians Recommending Automated Insulin Delivery (AID) Systems for People with Type 1 Diabetes (PwT1D): A Qualitative Study
Author Block: EMMA L. OSPELT, SUSAN THAPA, ORI ODUGBESAN, ASHER BECKWITT, KRISTINA COSSEN, GRENYE O'MALLEY, NESTORAS MATHIOUDAKIS, MARINA BASINA, KAI JONES, STEPHANIE CROSSEN, DEBORAH PLANTE, ELIZABETH A. MANN, Boston, MA, United States, MD, Atlanta, GA, New York City, NY, Baltimore, MD, Stanford, CA, St Louis, MO, Sacramento, CA, Madison, WI
Introduction and Objective: The purpose of this study was to better understand the factors that shape the shared decision-making process for recommending AID systems.
Methods: Focus groups were facilitated via Zoom among multidisciplinary teams from 20 diabetes centers participating in the T1D Exchange Quality Improvement Collaborative (T1DX-QI). Transcripts were coded and analyzed for common themes. Scripted questions were asked about whether pump features shape the participant’s recommendation (shapes decision, does not shape decision, N/A) of different AID systems for PwT1D, and a coding matrix table was created based on responses by prescribing clinicians.
Results: The features with the largest overall “influence” were hypo and hyperglycemia protection (92%) followed by CGM integration (70%); the extent that specific system features influenced recommendations differed based on the age of the individual with type 1 diabetes (T1D) (Figure 1). Patient preference of certain features emerged as an important theme. Limiting factors identified were CGM interoperability, smartphone syncing, insurance and cost, and literacy and language barriers.
Conclusion: AID system features may shape prescribing clinicians’ decisions to recommend specific AID systems differently for youth and adults. Additionally, patient preferences are integral to the shared decision-making.
