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用于治疗1型糖尿病的生物人工胰腺:荷兰医疗保健专业人员的观点

The bio-artificial pancreas to treat type 1 diabetes: Perspectives from healthcare professionals in the Netherlands.

作者信息

de Jongh Dide, Bunnik Eline, Ozcan Behiye, Zietse Robert, Massey Emma

机构信息

Erasmus MC Transplant Institute, Department of Internal Medicine, University Medical Centre Rotterdam, 3000 CA Rotterdam, the Netherlands.

Department of Medical Ethics, Philosophy and History of Medicine, Erasmus MC, University Medical Centre Rotterdam, 3000 CA Rotterdam, the Netherlands.

出版信息

J Clin Transl Endocrinol. 2024 Oct 17;38:100372. doi: 10.1016/j.jcte.2024.100372. eCollection 2024 Dec.

Abstract

AIMS

Healthcare professionals are relevant stakeholders because of their gatekeeper role in the clinic. This study aims to explore their perspectives on the potential future clinical implementation of the bio-artificial pancreas (BAP) for people with type 1 diabetes, and suitable target groups.

METHODS

Semi-structured interviews were conducted with 17 healthcare professionals, including endocrinologists, nurses, and pancreas transplant surgeons. Inclusion was stopped once data saturation was reached. The audiotaped interviews were transcribed verbatim. Qualitative content analysis using an inductive approach was conducted to develop themes within a coding framework.

RESULTS

Three main themes emerged: (1) hoped-for benefits, which included improved clinical outcomes, enhanced sense of normality, reduced mental burden for patients and their significant others, greater societal participation, and lower costs; (2) concerns, which included safety and effectiveness, inequitable access, accurate information, control over self-management, and organizational challenges; and (3) allocating the BAP during initial implementation, which included prioritizing people who lack effective treatment options, people with mental health issues, and vulnerable people.

CONCLUSIONS

The results of this study are important for researchers and practitioners involved in the development of the BAP, so that they can align its design and the process of clinical implementation with healthcare professionals' perspectives.

摘要

目的

医疗保健专业人员因其在诊所中的把关人角色而成为相关利益攸关方。本研究旨在探讨他们对生物人工胰腺(BAP)未来在1型糖尿病患者中临床应用的潜在可能性以及合适目标群体的看法。

方法

对17名医疗保健专业人员进行了半结构化访谈,包括内分泌学家、护士和胰腺移植外科医生。一旦达到数据饱和,就停止纳入。对录音访谈进行逐字转录。采用归纳法进行定性内容分析,以在编码框架内形成主题。

结果

出现了三个主要主题:(1)期望的益处,包括改善临床结果、增强正常感、减轻患者及其重要他人的心理负担、增加社会参与度以及降低成本;(2)担忧,包括安全性和有效性、不公平获取、准确信息、自我管理控制以及组织挑战;(3)在初始实施阶段分配BAP,包括优先考虑缺乏有效治疗选择的人、有心理健康问题的人以及弱势群体。

结论

本研究结果对参与BAP研发的研究人员和从业者很重要,这样他们就可以使BAP的设计和临床实施过程与医疗保健专业人员的观点保持一致。

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