Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand.
OpenAPS, Seattle, Washington, USA.
Diabet Med. 2022 May;39(5):e14750. doi: 10.1111/dme.14750. Epub 2021 Dec 7.
Open-source automated insulin delivery (AID) is a user-driven treatment modality used by thousands globally. Healthcare professionals' (HCPs) ability to support users of this technology is limited by a lack of knowledge of these systems.
To describe the challenges experienced by HCPs supporting participants' use of open-source automated insulin delivery in the Community deRivEd AuTomatEd insulin delivery (CREATE) study.
Data were collected prospectively from the study team's fortnightly meetings and Slack Workspace (Slack Technologies, Ltd. 2018) during the first 4 months of the trial. Key topics were identified from minutes of meetings. Slack conversations were categorised by topic, with the number of posts per conversation, number of sites per conversation and involvement of experts in open-source AID being recorded.
In the first 4 months of the trial, there were 254 conversations in Slack with a mean of 5.2 (±4.25) posts per conversation. The most frequent learning challenge was insulin pump and cannula problems relating to the DANA-i insulin pump, which totalled 24.0% of all conversations. Experts on open-source AID use were involved in 83.3% of conversations.
A significant proportion of challenges related to specific devices, rather than AID. Challenges relating to the functioning of open-source AID were more likely to involve input from experts in open-source AID. This is the first report of challenges experienced by a multidisciplinary team in a supported open-source environment that may inform expectations in routine clinical care.
开源自动化胰岛素输送(AID)是一种由全球数千人使用的用户驱动的治疗方式。由于缺乏对这些系统的了解,医疗保健专业人员(HCPs)支持使用这种技术的用户的能力受到限制。
描述在社区衍生的自动胰岛素输送(CREATE)研究中,HCPs 在支持参与者使用开源自动化胰岛素输送方面所面临的挑战。
从研究团队的每两周一次的会议和 Slack 工作区(Slack Technologies,Ltd. 2018)中收集前瞻性数据,在试验的前 4 个月内。从会议记录中确定关键主题。根据主题对 Slack 对话进行分类,记录每次对话的帖子数、每个对话的站点数以及开源 AID 专家的参与情况。
在试验的前 4 个月里,Slack 上有 254 次对话,每次对话的平均帖子数为 5.2(±4.25)。最常见的学习挑战是与 DANA-i 胰岛素泵有关的胰岛素泵和导管问题,占所有对话的 24.0%。开源 AID 使用方面的专家参与了 83.3%的对话。
相当一部分挑战与特定设备有关,而不是与 AID 有关。与开源 AID 功能相关的挑战更有可能涉及开源 AID 专家的意见。这是第一个报告多学科团队在支持性开源环境中遇到的挑战的报告,可能会影响常规临床护理的预期。