TY - JOUR
T1 - Barriers and facilitators to accessing insulin pump therapy by adults with type 1 diabetes mellitus
T2 - a qualitative study
AU - Gajewska, Katarzyna A.
AU - Biesma, Regien
AU - Bennett, Kathleen
AU - Sreenan, Seamus
N1 - Publisher Copyright:
© 2020, Springer-Verlag Italia S.r.l., part of Springer Nature.
PY - 2021/1
Y1 - 2021/1
N2 - Aims: Uptake of continuous subcutaneous insulin infusion (CSII) by people with diabetes (PwD) in Ireland is low and exhibits regional variation. This study explores barriers and facilitators to accessing CSII by adults with Type 1 diabetes mellitus. Research design and methods: A qualitative study employing focus groups with adults with Type 1 diabetes mellitus (n = 26) and semi-structured interviews with health care professionals (HCP) and other key stakeholders (n = 21) was conducted. Reflexive thematic analysis was used to analyze data, using NVivo. Results: Four main themes comprising barriers to or facilitators of CSII uptake were identified. These included: (1) awareness of CSII and its benefits, (2) the structure of diabetes services, (3) the capacity of the diabetes service to deliver the CSII service, and (4) the impact of individuals’ attitudes and personal characteristics—both PwD, and HCP. Each of these themes was associated with a number of categories, of which 18 were identified and explored. If the structure of the health-service is insufficient and capacity is poor (e.g., under-resourced clinics), CSII uptake appears to be impacted by individuals’: interest, attitude, willingness and motivation, which may intensify the regional inequality in accessing CSII. Conclusions: This study identified factors that contribute to gaps in the delivery of diabetes care that policy-makers may use to improve access to CSII for adult PwD.
AB - Aims: Uptake of continuous subcutaneous insulin infusion (CSII) by people with diabetes (PwD) in Ireland is low and exhibits regional variation. This study explores barriers and facilitators to accessing CSII by adults with Type 1 diabetes mellitus. Research design and methods: A qualitative study employing focus groups with adults with Type 1 diabetes mellitus (n = 26) and semi-structured interviews with health care professionals (HCP) and other key stakeholders (n = 21) was conducted. Reflexive thematic analysis was used to analyze data, using NVivo. Results: Four main themes comprising barriers to or facilitators of CSII uptake were identified. These included: (1) awareness of CSII and its benefits, (2) the structure of diabetes services, (3) the capacity of the diabetes service to deliver the CSII service, and (4) the impact of individuals’ attitudes and personal characteristics—both PwD, and HCP. Each of these themes was associated with a number of categories, of which 18 were identified and explored. If the structure of the health-service is insufficient and capacity is poor (e.g., under-resourced clinics), CSII uptake appears to be impacted by individuals’: interest, attitude, willingness and motivation, which may intensify the regional inequality in accessing CSII. Conclusions: This study identified factors that contribute to gaps in the delivery of diabetes care that policy-makers may use to improve access to CSII for adult PwD.
KW - Continuous subcutaneous insulin infusion
KW - Diabetes technology
KW - Health-services research
KW - Insulin pumps
KW - Medical device
KW - Qualitative research
KW - Type 1 diabetes
UR - http://www.scopus.com/inward/record.url?scp=85089961258&partnerID=8YFLogxK
U2 - 10.1007/s00592-020-01595-5
DO - 10.1007/s00592-020-01595-5
M3 - Article
C2 - 32862261
AN - SCOPUS:85089961258
SN - 0940-5429
VL - 58
SP - 93
EP - 105
JO - Acta Diabetologica
JF - Acta Diabetologica
IS - 1
ER -