Macdonald Christy, Lunt Helen, Downie Michelle, Kendall Deborah
1 Department of General Medicine, Christchurch Hospital, Christchurch, New Zealand.
2 Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand.
J Diabetes Sci Technol. 2017 Sep;11(5):1001-1006. doi: 10.1177/1932296817693016. Epub 2017 Feb 1.
Many governments and insurers are driving down the cost of medical devices, including glucose meters, by the central management of purchasing decisions. We report patients' responses to an "enforced" change in brand of glucose meter, one year after the introduction of a national sole supplier arrangement for funded glucose meters and strips.
Specialist diabetes clinic attendees from two geographical locations completed a questionnaire one year after the final meter changeover date. In the first location, consecutive patients were asked to complete a glucose meter satisfaction questionnaire during their clinic visit. In the second location, this questionnaire was mailed to clinic attendees. Responses to open questions were analyzed thematically.
Response rates were 85% and 31% from the first and second locations, respectively and 378 questionnaires were suitable for analysis, 309 from the first and 69 from the second location. Insulin users composed 90% of participants. Results from the two locations were broadly similar. Most participants adapted well to the changeover, however 36% reported ongoing dissatisfaction with their "new" meter. The commonest concern, expressed by 23% of participants, related to meter accuracy and precision.
One year after glucose meter changeover, a third of participants expressed dissatisfaction with their meter, with many participants describing a failure to adapt to the sole supplier arrangement. Providing a choice of meters and strips, ideally from two or more brands that have demonstrable differences in technical and ergonomic features, is likely to produce higher overall patient satisfaction than is a sole supplier arrangement.
许多政府和保险公司通过集中管理采购决策来降低包括血糖仪在内的医疗设备成本。我们报告了在国家对资助的血糖仪及试纸实行单一供应商安排一年后，患者对血糖仪品牌“强制”更换的反应。
来自两个地理位置的糖尿病专科门诊患者在最终血糖仪更换日期一年后完成了一份问卷。在第一个地点，连续就诊的患者在门诊就诊期间被要求完成一份血糖仪满意度问卷。在第二个地点，这份问卷被邮寄给门诊患者。对开放式问题的回答进行了主题分析。
第一个和第二个地点的回复率分别为85%和31%，共有378份问卷适合分析，其中309份来自第一个地点，69份来自第二个地点。胰岛素使用者占参与者的90%。两个地点的结果大致相似。大多数参与者很好地适应了更换，然而36%的人报告对他们的“新”血糖仪仍不满意。23%的参与者表达的最常见担忧与血糖仪的准确性和精密度有关。
血糖仪更换一年后，三分之一的参与者对他们的血糖仪表示不满，许多参与者表示未能适应单一供应商安排。提供血糖仪及试纸的选择，理想情况下是来自两个或更多在技术和人体工程学特征上有明显差异的品牌，可能会比单一供应商安排产生更高的患者总体满意度。
