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Initiating hybrid closed loop: A program evaluation of an educator‐led Control‐IQ follow‐up at a large pediatric clinic

BACKGROUND: Control‐IQ (Tandem Diabetes) is a hybrid closed‐loop (HCL) system that users self‐initiate after completing online training. Best practices for clinical follow‐up are not known. Our quality improvement objective was to evaluate the usefulness of an educator‐led follow‐up program for new...

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Autores principales: Messer, Laurel H., Berget, Cari, Ernst, Ashlee, Towers, Lindsey, Slover, Robert H., Forlenza, Gregory P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons A/S 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8252603/
https://www.ncbi.nlm.nih.gov/pubmed/33502062
http://dx.doi.org/10.1111/pedi.13183
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author Messer, Laurel H.
Berget, Cari
Ernst, Ashlee
Towers, Lindsey
Slover, Robert H.
Forlenza, Gregory P.
author_facet Messer, Laurel H.
Berget, Cari
Ernst, Ashlee
Towers, Lindsey
Slover, Robert H.
Forlenza, Gregory P.
author_sort Messer, Laurel H.
collection PubMed
description BACKGROUND: Control‐IQ (Tandem Diabetes) is a hybrid closed‐loop (HCL) system that users self‐initiate after completing online training. Best practices for clinical follow‐up are not known. Our quality improvement objective was to evaluate the usefulness of an educator‐led follow‐up program for new HCL users in a type 1 diabetes pediatric clinic. METHODS: We implemented an ''HCLCheck‐in'' program, first determining when users started HCL, then having diabetes educators contact them for a follow‐up call 2‐weeks after start. Educators used a Clinical Tool to inform insulin dose and behavior recommendations, and used four benchmarks to determine need for further follow‐up: ≥71% HCL use, ≥71% CGM use, ≥60% Time‐in‐Range (TIR, 70–180 mg/dL), <5% below 70 mg/dL. Family and educator satisfaction were surveyed. RESULTS: One‐hundred‐twenty‐three youth [mean age 13.6 ± 3.7 y, 53.7% female, mean HbA1c 7.6 ± 1.4% (60 mmol/mol)] completed an HCLCheck‐in call a median (IQR) of 18(15, 21) days post‐HCL start. 74 users (60%) surpassed benchmarks with 94% HCL use and 71% TIR. Of the 49 who did not, 16 completed a second call, and improved median TIR 12.5% (p = 0.03). HCL users reported high satisfaction with the program overall [median 10 (9, 10) out of 10]. Educators spent a median of 45 (32,70) minutes per user and rated satisfaction with the program as 8 (7,9.5) and the Tool as 9 (9, 10). CONCLUSION: Our HCLCheck‐in program received high satisfaction ratings and resulted in improved TIR for those initially not meeting benchmarks, suggesting users may benefit from early follow‐up. Similar programs may be beneficial for other new technologies.
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spelling pubmed-82526032021-07-09 Initiating hybrid closed loop: A program evaluation of an educator‐led Control‐IQ follow‐up at a large pediatric clinic Messer, Laurel H. Berget, Cari Ernst, Ashlee Towers, Lindsey Slover, Robert H. Forlenza, Gregory P. Pediatr Diabetes Clinical Care and Technology BACKGROUND: Control‐IQ (Tandem Diabetes) is a hybrid closed‐loop (HCL) system that users self‐initiate after completing online training. Best practices for clinical follow‐up are not known. Our quality improvement objective was to evaluate the usefulness of an educator‐led follow‐up program for new HCL users in a type 1 diabetes pediatric clinic. METHODS: We implemented an ''HCLCheck‐in'' program, first determining when users started HCL, then having diabetes educators contact them for a follow‐up call 2‐weeks after start. Educators used a Clinical Tool to inform insulin dose and behavior recommendations, and used four benchmarks to determine need for further follow‐up: ≥71% HCL use, ≥71% CGM use, ≥60% Time‐in‐Range (TIR, 70–180 mg/dL), <5% below 70 mg/dL. Family and educator satisfaction were surveyed. RESULTS: One‐hundred‐twenty‐three youth [mean age 13.6 ± 3.7 y, 53.7% female, mean HbA1c 7.6 ± 1.4% (60 mmol/mol)] completed an HCLCheck‐in call a median (IQR) of 18(15, 21) days post‐HCL start. 74 users (60%) surpassed benchmarks with 94% HCL use and 71% TIR. Of the 49 who did not, 16 completed a second call, and improved median TIR 12.5% (p = 0.03). HCL users reported high satisfaction with the program overall [median 10 (9, 10) out of 10]. Educators spent a median of 45 (32,70) minutes per user and rated satisfaction with the program as 8 (7,9.5) and the Tool as 9 (9, 10). CONCLUSION: Our HCLCheck‐in program received high satisfaction ratings and resulted in improved TIR for those initially not meeting benchmarks, suggesting users may benefit from early follow‐up. Similar programs may be beneficial for other new technologies. John Wiley & Sons A/S 2021-03-16 2021-06 /pmc/articles/PMC8252603/ /pubmed/33502062 http://dx.doi.org/10.1111/pedi.13183 Text en © 2021 The Authors. Pediatric Diabetes published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Clinical Care and Technology
Messer, Laurel H.
Berget, Cari
Ernst, Ashlee
Towers, Lindsey
Slover, Robert H.
Forlenza, Gregory P.
Initiating hybrid closed loop: A program evaluation of an educator‐led Control‐IQ follow‐up at a large pediatric clinic
title Initiating hybrid closed loop: A program evaluation of an educator‐led Control‐IQ follow‐up at a large pediatric clinic
title_full Initiating hybrid closed loop: A program evaluation of an educator‐led Control‐IQ follow‐up at a large pediatric clinic
title_fullStr Initiating hybrid closed loop: A program evaluation of an educator‐led Control‐IQ follow‐up at a large pediatric clinic
title_full_unstemmed Initiating hybrid closed loop: A program evaluation of an educator‐led Control‐IQ follow‐up at a large pediatric clinic
title_short Initiating hybrid closed loop: A program evaluation of an educator‐led Control‐IQ follow‐up at a large pediatric clinic
title_sort initiating hybrid closed loop: a program evaluation of an educator‐led control‐iq follow‐up at a large pediatric clinic
topic Clinical Care and Technology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8252603/
https://www.ncbi.nlm.nih.gov/pubmed/33502062
http://dx.doi.org/10.1111/pedi.13183
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