Remote care and insulin pump education: Current provision and healthcare professionals’ experience

This survey from the UK Diabetes Technology Network (DTN UK) sought to determine the impact of the COVID-19 pandemic on the delivery of insulin pump training in the UK, and to assess healthcare professionals’ experience of the remote care that was established. The anonymous, 48-question survey was distributed online via the DTN-UK and the Association of Children’s Diabetes Clinicians, and took place between 18 November and 15 December 2020.

A total of 143 healthcare professionals, from 75 centres, responded. The majority were consultants or diabetes specialist nurses, and most (78%) were working in adult care. The majority of consultations over the study period were conducted via telephone (median, 50%), followed by face-to-face (20%) and via video (10%). Telephone consultations tended to last only 20 minutes, compared to 30 minutes with face-to-face and video consultations.

Overall, 63% of participants responded that remote consultations were an effective strategy to deliver care. Access to patients’ data and patients’ digital literacy were viewed as the greatest barriers and facilitators of an effective remote consultation; notably, 46% or respondents rated the likelihood of having access to patients’ data as 4 or below on a 7-point Likert scale. Devices with smartphone-based automated cloud uploads were felt to make consultations easier (73% of participants) and more effective (85%).

A reduction in new pump starts and renewals of out-of-warranty pumps was reported by 73% and 61% of respondents, respectively. Common barriers included patient digital literacy (61%), limited healthcare professional experience (46%) and time required per patient (44%). Furthermore, smaller diabetes centres (those with fewer than 100 pump users) were more likely to have their pump starts and renewals reduced than larger centres (more than 200 pump users), possibly due to staff being redeployed to frontline medical services and routine care being delayed.

The authors conclude that, while healthcare professionals were generally supportive of virtual care models, several factors such as patient digital literacy need to be addressed to improve virtual care delivery and diabetes device training. They highlight recent DTN-UK guidance to support teams in starting CGM and insulin pumps remotely.

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