Article Figures & Data
Tables
- Table 1.
Guide for Interviews Conducted with US Primary Care Physicians, NPs and PAs (n = 55), 2020
1. Now I’d like to understand a typical visit for a patient with diabetes, including the use of CGM. Think about a day you saw one or more patients with diabetes. Tell me about what caring for those patients is like. 2. In your experience, what are the greatest barriers to prescribing or encouraging the use of CGM to your patients with diabetes? 3. In your experience, what are the greatest facilitators to prescribing or encouraging the use of CGM to your patients with diabetes? 4. What resources would you need to feel comfortable prescribing CGM to your patients with diabetes (more often)? 5. Overall, what do you think about CGM? Abbreviations: NPs, nurse practitioners; PAs, physician assistants; CGM, continuous glucose monitoring.
- Table 2.
Interview Participant Characteristics (n = 55 US Primary Care Physicians, NPs and PAs), 2020
Participant characteristic % n Professional role Attending, faculty, or community physician 78.2 43 Resident physician 7.3 4 Nurse practitioner or physician assistant 14.6 8 Primary setting Private practice 23.6 13 Federally qualified health center or similar 21.8 12 Hospital-owned practice 20.0 11 Academic medical center 14.6 8 Community health center 10.9 6 Other 9.1 5 Specialty Family medicine 83.6 46 Internal medicine 7.3 4 Internal medicine-pediatrics 1.8 1 None specified 7.3 4 Years since training 0 5.5 3 1 to 5 30.9 17 6 to 10 21.8 12 11 to 15 16.4 9 16 to 20 3.6 2 More than 20 21.8 12 CGM experience Heard of but never had patients on CGM 20.0 11 Had patients on CGM but never prescribed 43.6 24 Have prescribed CGM 36.4 20 Likelihood to prescribe CGM Not at all likely 12.7 7 Somewhat likely 32.7 18 Moderately likely 18.2 10 Very likely 36.4 20 Geographic location Rural 38.2 21 Distance from endocrinologist ≤40 miles 69.1 38 >40 miles 30.9 17 Payer mix Medicare – 50% or less 83.6 46 Medicaid – 50% or less 74.6 41 Private – 50% or less 81.8 45 No insurance – 50% or less 94.4 51 Region of United States Northeast 9.1 5 Midwest 21.8 12 South 12.7 7 West 56.4 31 Sample cluster AAFP NRN 54.5 30 Meta-LARC 45.5 25 Abbreviations: NPs, nurse practitioners; PAs, physician assistants; CGM, continuous glucose monitoring; AAFP NRN, American Academy of Family Physicians National Research Network; Meta-LARC, Meta-network Learning and Research Center.
- Table 3.
Resources to Support Patient Education on CGM Suggested by US Primary Care Physicians, NPs and PAs (n = 55), 2020
Category Content Format and Considerations Patient education materials The benefits of using CGM
Pamphlets or handouts that patients could view in the office and take home; this format could also benefit patients without internet access
Consider reading level and include languages other than English
The difference between CGM and traditional glucose meter
How to properly apply and use the sensor
How to interpret and act on CGM readings (e.g., how to adjust insulin dosing or medications)
Sample CGM device in office A CGM device in their office for patient demonstrations
The hands-on experience could increase both patients’ comfort and confidence in using the device and clinicians’ comfort with prescribing
Additional personnel in practice Staff for one-on-one patient support and education
Registered nurses
Additional staff and clinicians who are knowledgeable about CGM and can assist patients if the prescribing clinician were unavailable
Diabetes care and education specialists
Clinical pharmacists
Integration of CGM data into electronic health record (EHR) Ongoing transfer of CGM data from patients’ device
Integration and compatibility with practice’s current EHR system
CGM data available to review in patient’s EHR record during visit
Abbreviations: NPs, nurse practitioners; PAs, physician assistants; CGM, continuous glucose monitoring.
- Table 4.
Educational Topics of Interest for Practice Teams Identified in Interviews with Primary Care Physicians, NPs and PAs (n = 55), 2020
Benefits and health outcomes from using CGM
How to properly apply and use the sensor
How to interpret and act on CGM readings
Which patients would be appropriate candidates for CGM
Differences between the various CGM systems (e.g. personal/professional or different manufacturers)
Better understanding of how CGM glucose readings and capillary glucose readings differ
Insurance coverage questions:
o. Patient eligibility for insurance coverage
o. What specifically would be covered (e.g., initial device, number of sensors per month, percentage of cost covered)
o. The prior authorization process
o. Step-by-step guide as to what information and documentation is needed to ensure coverage
o. List of which insurance providers cover CGM
o. Checklist or standardized forms for prior authorizations
Abbreviations: NPs, nurse practitioners; PAs, physician assistants; CGM, continuous glucose monitoring.
