TY - JOUR
T1 - Healthcare professional requirements for the care of adult diabetes patients managed with insulin pumps in Australia
AU - Xu, S.
AU - Alexander, K.
AU - Bryant, W.
AU - Cohen, N.
AU - Craig, M.E.
AU - Forbes, M.
AU - Fulcher, G.
AU - Greenaway, T.
AU - Harrison, N.
AU - Holmes-Walker, D. J.
AU - Howard, G.
AU - Jackson, J.
AU - Jenkins, A.
AU - Kamp, M.
AU - Kaye, Joey
AU - Sinha, A.
AU - Stranks, S.
AU - O'Neal, David
AU - The Australian National Adult Insulin Pump Therapy Working Group
AU - Colman, Peter
PY - 2015/1
Y1 - 2015/1
N2 - Background: 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. Aim: This study aims to determine HCP time spent in IPT patient care to inform resource planning for optimal IPT delivery. Methods: 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. Results: 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. Conclusions: 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.
AB - Background: 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. Aim: This study aims to determine HCP time spent in IPT patient care to inform resource planning for optimal IPT delivery. Methods: 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. Results: 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. Conclusions: 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.
KW - Health resource
KW - Health service need and demand
KW - Insulin
KW - Insulin infusion system
KW - Type 1 diabetes mellitus
UR - http://www.scopus.com/inward/record.url?scp=84920986736&partnerID=8YFLogxK
U2 - 10.1111/imj.12619
DO - 10.1111/imj.12619
M3 - Article
C2 - 25370368
AN - SCOPUS:84920986736
SN - 1444-0903
VL - 45
SP - 86
EP - 93
JO - Internal Medicine Journal
JF - Internal Medicine Journal
IS - 1
ER -
