UK service level audit of insulin pump therapy in paediatrics

Ghatak, A, Paul, P, Hawcutt, DB ORCID: 0000-0002-8120-6507, White, HD, Furlong, NJ, Saunders, S, Morrison, G, Langridge, P and Weston, PJ (2015) UK service level audit of insulin pump therapy in paediatrics. DIABETIC MEDICINE, 32 (12). pp. 1652-1657.

Text Diabetes CSII Audit revisions AG 7 2 UNMARKED.docx - Unspecified Access to this file is embargoed until Unspecified. Download (44kB)

Abstract

<h4>Aim</h4>To conduct an audit of insulin pump therapy in the UK after the issue of guidelines for the use of continuous subcutaneous insulin infusion by NICE in 2008 (Technology Appraisal 151).<h4>Methods</h4>All centres in the UK, providing pump services to children and young people were invited to participate in an online audit. Audit metrics were aligned to NICE Technology Appraisal 151 and an electronic data collection tool was used.<h4>Results</h4>Of the 176 UK centres identified as providing pump services, 166 (94.3%) participated in the study. A total of 5094 children and young people were identified as using continuous subcutaneous insulin infusion (19% of all paediatric patients with Type 1 diabetes), with a median (range) of 16.9 (0.67-69.4)% per centre. Units had a median of 0.58 consultant sessions, 0.43 full-time equivalent diabetic specialist nurses, and 0.1 full-time equivalent dieticians delivering the pump service. The majority of this time was not formally funded. Families could access 24-h clinical and technical support (83% units), although the delivery varied between consultant, diabetic specialist nurse and company representatives. Only 53% of units ran, or accessed, structured education programmes for continuous subcutaneous insulin infusion use. Most units (86%) allowed continuous subcutaneous insulin infusion use for paediatric inpatients, but only 56% had written guidelines for this scenario. Nine percent of units had encountered funding refusal for a patient fulfilling NICE (Technology Appraisal 151) criteria.<h4>Conclusion</h4>The number of children and young people on continuous subcutaneous insulin infusion therapy is consistent with numbers estimated by NICE. There is a worrying lack of funded healthcare professional time. The audit also identified gaps in the provision of structured education and absence of written inpatient guidelines.

Item Type:	Article
Uncontrolled Keywords:	Humans, Diabetes Mellitus, Type 1, Clinical Protocols, Combined Modality Therapy, Insulin Infusion Systems, Health Care Surveys, Motor Activity, Life Style, Adolescent Medicine, Needs Assessment, Internet, Adolescent, Child, Patient Care Team, Guideline Adherence, Medical Audit, Patient Education as Topic, Practice Guidelines as Topic, Diet, Diabetic, United Kingdom, Workforce
Subjects:	?? RJ ?? ?? RM ??
Depositing User:	Symplectic Admin
Date Deposited:	13 Jan 2016 10:26
Last Modified:	15 Dec 2022 12:06
DOI:	10.1111/dme.12782
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/2042300