Healthcare professional requirements for the care of adult diabetes patients managed with insulin pumps in Australia. Issue 1 (January 2015)

• Record Type: Journal Article
• Authors: Xu, S.; Alexander, K.; Bryant, W.; Cohen, N.; Craig, M. E.; Forbes, M.; Fulcher, G.; Greenaway, T.; Harrison, N.; Holmes‐Walker, D. J.; Howard, G.; Jackson, J.; Jenkins, A.; Kamp, M.; Kaye, J.; Sinha, A.; Stranks, S.; O'Neal, D.; Colman, P.; (The Australian National Adult Insulin Pump Therapy Working Group)
• Is Part Of: Internal medicine journal. Volume 45:Issue 1(2015)
• Page Start: 86
• Page End: 93
• Publication Date: 2015-01
• Subjects: Medicine -- Periodicals; 616
• DOI: 10.1111/imj.12619
• Languages: English
• ISSNs: 1444-0903

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="imj12619-sec-0001" sec-type="section"> <title>Background</title> <p>Healthcare professional (HCP) time supporting insulin pump therapy (IPT) has not been documented, yet it is important in planning and allocating resources for effective care.</p> </sec> <sec id="imj12619-sec-9001" sec-type="section"> <title>Aim</title> <p>This study aims to determine HCP time spent in IPT patient care to inform resource planning for optimal IPT delivery.</p> </sec> <sec id="imj12619-sec-0002" sec-type="section"> <title>Methods</title> <p>Twenty‐four Australian adult IPT‐experienced institutions (14 government funded, seven private, three both) collected data between April 2012 and January 2013 prospectively, including: patient demographics, HCP classification, purpose of HCP–patient interaction, interaction mode and HCP time with the patient. A subset of patients was tracked from pre‐pump education until stable on IPT.</p> </sec> <sec id="imj12619-sec-0003" sec-type="section"> <title>Results</title> <p>Data on 2577 HCP‐adult patient interactions (62% face‐to‐face, 29% remote, 9% administrative) were collected over 12.2 ± 6.4 weeks for 895 patients; age 35.4 ± 14.2 years; 67% female; 99% type 1 diabetes, representing 25% of all IPT patients of the institutions. Time (hours) spent on IPT interactions per centre per week were: nurses 5.4 ± 2.8, dietitians 0.4 ± 0.2 and doctors 1.0 ± 0.5. IPT starts accounted for 48% of IPT interaction time. The percentage of available diabetes clinic time spent on outpatient IPT interactions was 20.4%, 4.6% and 2.7% for nurses, dietitians and doctors respectively. Fifteen patients tracked from pre‐pump to stabilisation over 11.8 ± 4.5 weeks, required a median (range) of 9.2 (3.0–20.9), 2.4 (0.5–6.0) and 1.8 (0.5–5.4) hours per patient from nurses, dietitians and doctors respectively.</p> </sec> <sec id="imj12619-sec-0004" sec-type="section"> <title>Conclusions</title> <p>IPT patient care represents a substantial investment in HCP time, particularly for nurses. Funding models for IPT care need urgent review to ensure this now mainstream therapy integrates well into healthcare resources.</p> </sec> </abstract>