Understanding patient and clinician glucose reporting preferences in type 1 diabetes: Ambulatory Glucose Profile (AGP) [abstract]
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Background and aims: A lack of a standardized glucose report and streamlined data acquisition across glucose monitoring devices has created frustration in clinics and reduced the use of glucose data in clinical encounters. Device specific reports are unique to each glucose monitoring device, are complex and not able to incorporate devices from different manufacturers into a single view. The AGP is simple one page report with 3 components: glucose metrics, graphic summary visualization of a 2 week glucose profile and a calendar view the glucose profiles from each of the days making up the summary profile view. The purpose of this novel research is to evaluate both patient (aim 1) and clinician (aim 3) utility and preference of streamlined standardized glucose reporting using Ambulatory Glucose Profile (AGP) reports. The first two sites participated in Time in Motion (TIM) evaluation as well as work flow mapping to determine an idealized glucose reporting work flow (aim 2). Materials and methods: Seven geographically and demographically diverse clinics with large patient populations with type 1 diabetes were selected. Twenty patients per clinic and up to four clinicians per clinic utilized a device download station to create a standardized SMBG or CGM AGP report. Both the patients and clinicians reviewed the report then responded to a survey about the AGP reports utility and their preferences when compared with their usual glucose reports. Results: Patients or their parents have reported a significantly higher preference for the AGP report than logbooks, device specific reports or from device displays (see Table). Patients and parents report significantly higher amounts of information, better information to support health routine changes, better understanding of their glucose patterns, more confidence in managing their glucose levels and seeing new trends from the AGP (see Table). Clinicians reported significantly higher preference of the AGP over other methods for seeing glucose trends and helping to educate patients about trends. TIM portions of the study showed significant savings in staff time (on average 4 to 15 minutes) per patient from this streamlined reporting system. Conclusion: This novel approach to glucose reporting has the ability to save staff time, improve patient and clinician interactions through shared understanding of the patient’s glucose profile and lead to more in depth individualized support for medication adjustment and health related behavior changes. Compared to the use of an HbA1c and inconsistent patient reporting of adverse glucose related events, the standardized use of a one page comprehensive glucose report (AGP) resulted in more personalized clinical decision making and significantly improved clinic workflow.