Healthcare professionals' views about how pregnant women can benefit from using a closed‐loop system: Qualitative study

Author:

Lawton Julia1ORCID,Rankin David1ORCID,Hartnell Sara2,Lee Tara34,Dover Anna R.5,Reynolds Rebecca M.56ORCID,Hovorka Roman78ORCID,Murphy Helen R.234ORCID,Hart Ruth I.1ORCID,

Affiliation:

1. Usher Institute, Medical School, University of Edinburgh Edinburgh UK

2. Cambridge University Hospitals NHS Foundation Trust Cambridge UK

3. Norwich Medical School Norwich UK

4. Norfolk & Norwich University Hospital NHS Foundation Trust Norwich UK

5. Edinburgh Centre for Endocrinology and Diabetes, Royal Infirmary of Edinburgh Edinburgh UK

6. Centre for Cardiovascular Science University of Edinburgh, Queen's Medical Research Institute Edinburgh UK

7. Wellcome Trust‐MRC Institute of Metabolic Science, University of Cambridge Cambridge UK

8. Department of Paediatrics University of Cambridge Cambridge UK

Abstract

AbstractBackgroundInterest is growing in how closed‐loop systems can support attainment of within‐target glucose levels amongst pregnant women with type 1 diabetes. We explored healthcare professionals' views about how, and why, pregnant women benefitted from using the CamAPS FX system during the AiDAPT trial.MethodsWe interviewed 19 healthcare professionals who supported women using closed‐loop during the trial. Our analysis focused on identifying descriptive and analytical themes relevant to clinical practice.ResultsHealthcare professionals highlighted clinical and quality‐of‐life benefits to using closed‐loop in pregnancy; albeit, they attributed some of these to the continuous glucose monitoring component. They emphasised that the closed‐loop was not a panacea and that, to gain maximum benefit, an effective collaboration between themselves, the woman and the closed‐loop was needed. Optimal performance of the technology, as they further noted, also required women to interact with the system sufficiently, but not excessively; a requirement that they felt some women had found challenging. Even where healthcare professionals felt that this balance was not achieved, they suggested that women had still benefitted from using the system. Healthcare professionals reported difficulties predicting how specific women would engage with the technology. In light of their trial experiences, healthcare professionals favoured an inclusive approach to closed‐loop rollout in routine clinical care.ConclusionsHealthcare professionals recommended that closed‐loop systems be offered to all pregnant women with type 1 diabetes in the future. Presenting closed‐loop systems to pregnant women and healthcare teams as one pillar of a three‐party collaboration may help promote optimal use.

Funder

National Institute for Health Research

Efficacy and Mechanism Evaluation Programme

National Institute for Health Research Cambridge Biomedical Research Centre

Juvenile Diabetes Research Foundation International

British Heart Foundation

Publisher

Wiley

Subject

Endocrinology,Endocrinology, Diabetes and Metabolism,Internal Medicine

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