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Co-designing a model of care for adults living with Cystic Fibrosis Related Diabetes
  • Shanal Kumar,
  • Michael Pallin,
  • Georgia Soldatos
Shanal Kumar
Monash Centre for Health Research and Implementation

Corresponding Author:[email protected]

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Michael Pallin
Monash Health
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Georgia Soldatos
Monash Centre for Health Research and Implementation
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Abstract

Background Cystic fibrosis (CF) related diabetes affects up to half of all adults with CF and is associated with higher morbidity and mortality. Our aim is to co-design an ideal model of care that integrates diabetes technology and better meets the needs of adults living with the condition to improve attendance, engagement, service satisfaction and clinical outcomes. Methods Using qualitative research methods, we evaluated disease perceptions, barriers and enablers to optimal CF-related diabetes management and service delivery. Integration of continuous glucose monitoring (CGM) was also explored. An initial broad purposive consumer survey was followed by focus groups with end-users. Grounded theory approach was utilized with major problem-areas identified then explored, coded and grouped into requisites for an ‘ideal model of care’ for adults living with CF-related diabetes. Results Two key themes emerged i) CGM was acceptable for use in adults with CF-related diabetes with many perceived benefits and should be integrated into the model of care, ii) an ideal model of care consisted of a dual-specialty service co-led by endocrinology and CF physicians and supported by diabetes nurse educator and CF dietitian with a goal to provide consistent and personalized diabetes management. Barriers to optimizing glycaemic control included diet, finger-prick testing, reduced access to CGM and pulmonary exacerbations. End-user feedback on CGM was overwhelmingly positive with regards to user operability. CGM was also identified as a tool that could be used to engage, educate and empower adults living with CF-related diabetes and facilitate constructive and personalized clinical decision-making by healthcare providers. Conclusion For adults living with CF, a diagnosis of diabetes is associated with increased treatment burden. End-users agreed CGM had many benefits and should be integrated into an ‘ideal model of care’ for CF-related diabetes that was co-led by endocrinology services integrated within a pre-existing CF service.
13 Oct 2023Submitted to Pediatric Pulmonology
13 Oct 2023Submission Checks Completed
13 Oct 2023Assigned to Editor
13 Oct 2023Review(s) Completed, Editorial Evaluation Pending
23 Oct 2023Reviewer(s) Assigned
28 Jan 2024Editorial Decision: Revise Major
13 Mar 20241st Revision Received
13 Mar 2024Submission Checks Completed
13 Mar 2024Assigned to Editor
13 Mar 2024Reviewer(s) Assigned
01 Apr 2024Review(s) Completed, Editorial Evaluation Pending
02 Apr 2024Editorial Decision: Revise Minor
08 Apr 20242nd Revision Received
10 Apr 2024Submission Checks Completed
10 Apr 2024Assigned to Editor
15 Apr 2024Review(s) Completed, Editorial Evaluation Pending
28 Apr 2024Editorial Decision: Accept