Current provision and HCP experiences of remote care delivery and diabetes technology training for people with type 1 diabetes in the UK during the COVID-19 pandemic

Diabet Med. 2022 Apr;39(4):e14755. doi: 10.1111/dme.14755. Epub 2021 Dec 21.

Abstract

Background: The COVID-19 pandemic has led to the rapid implementation of remote care delivery in type 1 diabetes. We studied current modes of care delivery, healthcare professional experiences and impact on insulin pump training in type 1 diabetes care in the United Kingdom (UK).

Methods: The UK Diabetes Technology Network designed a 48-question survey aimed at healthcare professionals providing care in type 1 diabetes.

Results: One hundred and forty-three healthcare professionals (48% diabetes physicians, 52% diabetes educators and 88% working in adult services) from approximately 75 UK centres (52% university hospitals, 46% general and community hospitals), responded to the survey. Telephone consultations were the main modality of care delivery. There was a higher reported time taken for video consultations versus telephone (p < 0.001). Common barriers to remote consultations were patient familiarity with technology (72%) and access to patient device data (67%). We assessed the impact on insulin pump training. A reduction in total new pump starts (73%) and renewals (61%) was highlighted. Common barriers included patient digital literacy (61%), limited healthcare professional experience (46%) and time required per patient (44%). When grouped according to size of insulin pump service, pump starts and renewals in larger services were less impacted by the pandemic compared to smaller services.

Conclusion: This survey highlights UK healthcare professional experiences of remote care delivery. While supportive of virtual care models, a number of factors highlighted, especially patient digital literacy, need to be addressed to improve virtual care delivery and device training.

Keywords: CSII; biotechnology; continuous blood glucose monitoring; healthcare delivery.

MeSH terms

  • Adult
  • Attitude of Health Personnel
  • Biomedical Technology / education
  • Blood Glucose Self-Monitoring / instrumentation
  • COVID-19 / epidemiology*
  • Delivery of Health Care / methods
  • Delivery of Health Care / organization & administration
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / epidemiology
  • Diabetes Mellitus, Type 1 / therapy*
  • Glycemic Control / instrumentation
  • Health Personnel* / organization & administration
  • Health Personnel* / psychology
  • Health Personnel* / statistics & numerical data
  • Humans
  • Insulin Infusion Systems
  • Pandemics
  • Patient Education as Topic / methods
  • Patient Education as Topic / organization & administration
  • Remote Consultation / methods
  • Remote Consultation / organization & administration
  • Self-Management / education*
  • Self-Management / methods
  • Self-Management / psychology
  • Surveys and Questionnaires
  • Telemedicine* / methods
  • Telemedicine* / organization & administration
  • Telemedicine* / statistics & numerical data
  • United Kingdom / epidemiology