Usher Institute, University of Edinburgh, Edinburgh, UK.
Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK.
Pediatr Diabetes. 2022 Sep;23(6):799-808. doi: 10.1111/pedi.13363. Epub 2022 May 25.
We explored parents' views about healthcare professionals having remote access to their young child's insulin and glucose data during a clinical trial to inform use of data sharing in routine pediatric diabetes care.
Interviews with 33 parents of 30 children (aged 1-7 years) with type 1 diabetes participating in a randomized trial (KidsAP02) comparing hybrid closed-loop system use with sensor-augmented pump therapy. Data were analyzed using a qualitative descriptive approach.
Parents reported multiple benefits to healthcare professionals being able to remotely access their child's glucose and insulin data during the trial, despite some initial concerns regarding the insights offered into everyday family life. Key benefits included: less work uploading/sharing data; improved consultations; and, better clinical input and support from healthcare professionals between consultations. Parents noted how healthcare professionals' real-time data access facilitated remote delivery of consultations during the COVID-19 pandemic, and how these were more suitable for young children than face-to-face appointments. Parents endorsed use of real-time data sharing in routine clinical care, subject to caveats regarding data access, security, and privacy. They also proposed that, if data sharing were used, consultations for closed-loop system users in routine clinical care could be replaced with needs-driven, ad-hoc contact.
Real-time data sharing can offer clinical, logistical, and quality-of-life benefits and enhance opportunities for remote consultations, which may be more appropriate for young children. Wider rollout would require consideration of ethical and cybersecurity issues and, given the heightened intrusion on families' privacy, a non-judgmental, collaborative approach by healthcare professionals.
我们探讨了家长对医疗保健专业人员在临床试验期间远程访问其年幼子女胰岛素和血糖数据的看法,以了解在常规儿科糖尿病护理中使用数据共享的情况。
对 33 名年龄在 1-7 岁的 1 型糖尿病儿童(参与随机试验 KidsAP02)的父母进行了访谈,该试验比较了混合闭环系统与传感器增强型泵治疗的使用。使用定性描述方法分析数据。
尽管最初对日常家庭生活提供的见解存在一些担忧,但父母报告说,在试验期间,医疗保健专业人员能够远程访问其子女的血糖和胰岛素数据,这有很多好处。主要好处包括:减少上传/共享数据的工作;改善咨询;以及在咨询之间获得更好的临床投入和来自医疗保健专业人员的支持。父母注意到医疗保健专业人员实时数据访问如何在 COVID-19 大流行期间方便地远程提供咨询,并且这些咨询比面对面预约更适合年幼的孩子。家长们认可在常规临床护理中使用实时数据共享,但需要注意数据访问、安全性和隐私问题。他们还提出,如果使用数据共享,则常规临床护理中闭环系统使用者的咨询可以用需求驱动、临时联系代替。
实时数据共享可以提供临床、后勤和生活质量方面的好处,并为远程咨询提供机会,这可能更适合年幼的孩子。更广泛的推广需要考虑伦理和网络安全问题,并且鉴于对家庭隐私的侵入性增加,医疗保健专业人员需要采取非评判性、协作性的方法。