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Patient Values and Preferences Regarding Continuous Subcutaneous Insulin Infusion and Artificial Pancreas in Adults with Type 1 Diabetes: A Systematic Review of Quantitative and Qualitative Data.
Muñoz-Velandia, Oscar; Guyatt, Gordon; Devji, Tahira; Zhang, Yuan; Li, Shelly-Anne; Alexander, Paul Elías; Henao, Diana; Gomez, Ana-María; Ruiz-Morales, Álvaro.
Afiliación
  • Muñoz-Velandia O; 1 Department of Internal Medicine and Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia.
  • Guyatt G; 2 Department of Clinical Epidemiology and Biostatistics, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia.
  • Devji T; 3 Department of Health Research Methods, Evidence, and Impact, McMaster University, Ontario, Canada.
  • Zhang Y; 3 Department of Health Research Methods, Evidence, and Impact, McMaster University, Ontario, Canada.
  • Li SA; 3 Department of Health Research Methods, Evidence, and Impact, McMaster University, Ontario, Canada.
  • Alexander PE; 4 Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Ontario, Canada.
  • Henao D; 3 Department of Health Research Methods, Evidence, and Impact, McMaster University, Ontario, Canada.
  • Gomez AM; 5 Endocrinology Unit, Department of Internal Medicine, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia.
  • Ruiz-Morales Á; 5 Endocrinology Unit, Department of Internal Medicine, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia.
Diabetes Technol Ther ; 21(4): 183-200, 2019 04.
Article en En | MEDLINE | ID: mdl-30839227
OBJECTIVE: We produced, through a systematic review of quantitative and qualitative evidence, a synthesis of the issues of importance (values and preferences) to adult patients with type 1 diabetes regarding treatment with automated insulin delivery systems. METHODS: We searched MEDLINE, CINAHL, EMBASE, and PsycINFO from the inception of each database through September 2018. We included studies examining patient values and preferences for outcomes related to continuous subcutaneous insulin infusion or artificial pancreas treatment. We compiled structured summaries of the results and assessed the relative importance of each outcome. GRADE (Grading of Recommendations, Assessment Development, and Evaluation) and CERQual (Confidence in Evidence from Reviews of Qualitative research) approaches provided the structure for the evaluation of the quality of evidence and confidence in the findings. A mixed-methods result-based convergent design provided the structure for integration and presentation of results. RESULTS: We reviewed 1665 unique citations; 19 studies (8 quantitative and 11 qualitative) proved eligible. Glycemic control is the key attribute that drives patients' preference. Reduction of glycemic variability and decreased incidence of hypoglycemia and chronic complications proved of intermediate importance and were ranked similarly to components of treatment burden, including the size and appearance of devices, cost, ease of use, and the embarrassment of public use. CONCLUSIONS: Clinician guidance may play a crucial role in determining patient values and preferences (for instance, patients' priority in glucose control rather than avoiding diabetic complications). Our results provide guidance for clinicians in discussing preferred insulin delivery systems with patients with type 1 diabetes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sistemas de Infusión de Insulina / Páncreas Artificial / Diabetes Mellitus Tipo 1 / Prioridad del Paciente / Insulina Tipo de estudio: Guideline / Qualitative_research / Systematic_reviews Aspecto: Patient_preference Límite: Humans Idioma: En Revista: Diabetes Technol Ther Asunto de la revista: ENDOCRINOLOGIA / TERAPEUTICA Año: 2019 Tipo del documento: Article País de afiliación: Colombia Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sistemas de Infusión de Insulina / Páncreas Artificial / Diabetes Mellitus Tipo 1 / Prioridad del Paciente / Insulina Tipo de estudio: Guideline / Qualitative_research / Systematic_reviews Aspecto: Patient_preference Límite: Humans Idioma: En Revista: Diabetes Technol Ther Asunto de la revista: ENDOCRINOLOGIA / TERAPEUTICA Año: 2019 Tipo del documento: Article País de afiliación: Colombia Pais de publicación: Estados Unidos