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提供者层面的障碍处方糖尿病技术的定性分析
Jennifer Maizel1, Ashby F Walker2, Anna Walls3
1Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA.
Journal of diabetes research
|November 17, 2025
概括
系统性障碍阻碍患者获得糖尿病技术,如持续血糖监测器 (CGM) 和胰岛素. 解决保险,电子健康记录和沟通对于公平的糖尿病护理至关重要.
科学领域:
- 糖尿病技术研究 糖尿病技术研究
- 医疗服务研究 医疗服务研究
- 质量健康研究 质量健康研究
背景情况:
- 患者对糖尿病技术的使用情况有很大差异.
- 服务不足的人群面临着提供者不情愿处方设备,如连续血糖监测器 (CGMs) 和胰岛素.
- 本研究探讨了医疗保健提供者的观点,探讨了处方和使用糖尿病技术的障碍和促进因素.
研究的目的:
- 阐明提供者对促进者和障碍者对糖尿病技术的处方和患者使用的观点.
- 确定影响糖尿病技术采用的系统性,人际和个人因素.
- 为改进糖尿病技术获取和利用的战略提供信息.
主要方法:
- 涉及16名来自学术卫生中心,VA医疗中心和安全网医院的糖尿病护理提供者 (MD,APRN,PharmD) 的定性研究.
- 数据收集包括2024年1月至5月期间进行的调查和半结构面试.
- 对采访成绩单的专题分析使用了适应的社会生态模型 (SEM) 作为编码框架.
主要成果:
- 医疗服务提供者估计,80%的符合条件的患者使用CGM,50%使用胰岛素,系统因素 (保险,成本) 是最大的障碍.
- 系统层面的问题,包括保险官僚主义,DME公司的互动和EHR的限制,是提供商发现的主要处方障碍.
- 人际障碍包括低健康素养和沟通挑战,而个人障碍则涉及患者对设备外观和知识差距的担忧.
结论:
- 需要进行多层次的干预,以提高糖尿病技术的处方和使用.
- 未来的努力应集中在改善电子健康记录功能,患者提供者沟通以及简化保险和DME流程上.
- 解决系统性障碍是改善获得基本糖尿病管理工具的公平获取的关键.
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