ORIGINAL RESEARCH
Tristen Hall, PhD, MPH; Meredith K. Warman, MPH; Tamara Oser, MD; Melissa K. Filippi, PhD, MPH; Brian Manning, MPH; Jennifer K. Carroll, MD; Donald E. Nease, Jr., MD; Elizabeth W. Staton, MSTC; Sean Oser, MD, MPH
Corresponding Author: Tristen Hall, PhD, MPH; Department of Family Medicine, University of Colorado Anschutz Medical Campus
Email: tristen.hall@ucdenver.edu
DOI: 10.3122/jabfm.2024.240049R1
Keywords: Continuous Glucose Monitoring, Primary Care Physicians, Primary Health Care, Qualitative Research, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, Wearable Technology
Dates: Submitted: 02-02-2024; Revised: 03-01-2024; Accepted: 03-11-2024
FINAL PUBLICATION: |HTML| |PDF|
BACKGROUND: Continuous glucose monitoring (CGM) for patients with type 1 and type 2 diabetes is associated with improved clinical, behavioral, and psychosocial patient health outcomes and is part of the American Diabetes Association’s Standards of Medical Care. CGM prescription often takes place in endocrinology practices, yet 50% of adults with type 1 diabetes and 90% of all people with type 2 diabetes receive their diabetes care in primary care settings. This study examined primary care clinicians’ perceptions of barriers and resources needed to support CGM use in primary care.
METHODS: This qualitative study used semi-structured interviews with primary care clinicians to understand patient-related barriers to CGM and resources needed as perceived by clinicians. Participants were recruited through practice-based research networks. Rapid qualitative analysis was used to summarize themes from interview findings.
RESULTS: We conducted interviews with 55 primary care clinicians across 21 states. Participants described CGM benefits for patients with varying levels of diabetes self-management and engagement. Major patient-related barriers to prescribing included lack of insurance coverage for CGM and discomfort with using devices or the amount of data generated. Participants identified resources needed to foster CGM prescribing, e.g., education, support staff, dedicated clinician time, and EHR compatibility.
CONCLUSION: Primary care clinicians face several challenges to prescribing CGM, but they are interested in learning more to help them offer it to their patients. This study reinforces the ongoing need for improved clinician education on CGM technology and continued expansion of insurance coverage for people with both type 1 and type 2 diabetes.