Determining the Perception and Willingness of Primary Care Providers to Prescribe Advanced Diabetes Technologies

Authors

Alexander O’Donovan, Penn State College of MedicineFollow
Sean M. Oser, University of Colorado School of Medicine; Penn State College of MedicineFollow
Jessica Parascando, Penn State College of MedicineFollow
Arthur Berg, Penn State College of MedicineFollow
Donald E. Nease Jr., University of Colorado School of MedicineFollow
Tamara K. Oser, University of Colorado School of Medicine; Penn State College of MedicineFollow

Publication Date

7-19-2021

Keywords

diabetes mellitus, primary health care, continuous glucose monitoring, closed-loop systems, technology, artificial pancreas

Abstract

Advanced diabetes technologies have produced increasingly favorable outcomes compared to older treatments. Disparities in practice resources have led to a treatment disparity by clinical setting, where endocrinologists typically prescribe far more such technologies than primary care providers (PCPs). Fully automated artificial pancreas systems (APS), which combine technologies to deliver and adjust insulin dosing continuously in response to automatic and continuous glucose monitoring, may be more straightforward for PCPs to prescribe and manage, therefore extending their benefit to more patients. We aimed to assess willingness of PCPs to prescribe advanced diabetes technologies through a cross-sectional survey of PCPs from 4 geographically diverse centers. While respondents were uncomfortable initiating (63 of 72, 88%) or adjusting (64 of 72, 89%) traditional insulin pumps, their views on APS were quite different: 71 of 76 (93%) saw advantages to prescribing APS by PCPs rather than only endocrinologists. Most would consider prescribing APS for type 1 diabetes (58 of 76, 76%) and type 2 diabetes (52 of 76, 68%). No differences were seen among attendings, residents, or nurse practitioners. APS were much more acceptable than traditional insulin pumps among this primary care sample. If successful, primary care management of closed-loop APS would greatly increase access to such therapies and reduce disparities among those patients who face more difficulty accessing subspecialty care than they do primary care.

Recommended Citation

O’Donovan A, Oser SM, Parascando J, Berg A, Nease DE Jr, Oser TK. Determining the perception and willingness of primary care providers to prescribe advanced diabetes technologies. J Patient Cent Res Rev. 2021;8:272-6. doi: 10.17294/2330-0698.1819