A Qualitative Evidence Synthesis of Continuous Subcutaneous Insulin Infusion: Acceptability, Implementation, Equity

Area of Science:

• Endocrinology
• Diabetes Management
• Qualitative Research

Background:

• Type 1 diabetes mellitus (T1DM) management presents challenges.
• Continuous subcutaneous insulin infusion (CSII) is an advanced therapy option.

Purpose of the Study:

• To synthesize perceptions of T1DM patients and healthcare professionals on CSII acceptability, implementation, and equity.
• To identify facilitators and barriers to CSII use.

Main Methods:

• Qualitative evidence synthesis.
• Systematic search of Medline, Embase, and Web of Science databases.
• Descriptive thematic synthesis following PRISMA and ENTREQ guidelines.

Main Results:

• Thirty-two qualitative studies were included.
• Seven themes emerged: acceptability, adaptation, facilitators, variability, barriers, implementation, and equity.
• CSII is mostly well-accepted, enhancing autonomy and relationships, but barriers exist.

Conclusions:

• CSII is largely acceptable for T1DM management, offering significant benefits.
• Addressing perceived barriers and ensuring equitable access are crucial for wider CSII implementation.
• Further research is needed on CSII-related inequalities.