Posted Jul 26 , 2019 01:44 AM
Establishing Expert, Multi-Disciplinary, Peer-Reviewed Consensus to Lead a Paradigm Shift in Optimal Blood Glucose Management.
Robertson DA, et al. Diabetes Therapy 2019_Online March 19
Institute Summary (excerpted from the abstract)
The National Health Service (NHS) in the UK appears unclear on how blood glucose monitoring (BGM) should be used to support diabetes patient care and empowerment, and local interpretation of NICE guidance on the availability of devices varies widely. An expert group of clinicians and commissioners considered BGM in terms of access, guidance, resources, data integration, patient education, and patient choice. The group generated a series of questions on BGM into a 38-statement questionnaire using Delphi methodology. This was circulated to clinicians involved in diabetes management across the UK, receiving 222 responses. From the questionnaire, 35 of the 38 statement responses showed >66% consensus, with 26 of these achieving >90% agreement.
Why is this important?
Despite clear demonstrations of the benefits of BGM meters that provide feedback to patients (Grady M, et al. J Diabetes Sci Technol. 2016;10(6):1324–32), and diabetes being almost universally managed in the UK by NHS professionals, there is an apparent lack of clarity within the NHS regarding emerging BGM technologies and their potential to positively impact service delivery and increase resource efficiency while supporting patient empowerment. The expert group in this study reviewed the responses and made recommendations based on the clear professional consensus demonstrated (see areas of consensus within the article). These included the need to use new technology and data integration and that wider factors, including patient choice rather than cost alone, should inform formulary inclusion of BGM equipment. Importantly, the need for patients to have real-time reports of their personal BGM data is supported by 94.5% of respondents. In addition, 92.5% of respondents agreed that formulary availability of BGM systems should not be driven by acquisition cost alone. While the NHS system differs from the systems used in the U.S., the principles remain the same!
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