Background: The number of patients treated with insulin pump therapy (IPT) is increasing dramatically but the demand upon health-care professional (HCP) time is unknown.
Aim: To determine the time spent by diabetes HCPs in IPT support.
Methods: Prospective data was collected between April 2012 and January 2013 on HCP classification (Doctor/ Nurse/ Dietician/ Company Trainer), stage of patient journey (pre-pump/ initiation/ post-initiation stabilisation/ renewal/ routine review), HCP time spent on each interaction, mode of interaction (face-to-face/ telephone/ electronic), admission status (inpatient/ ambulatory), patient age and duration of diabetes for HCP-patient interactions from 24 IPT experienced centres (public 14; private 7; both 3) around Australia (Vic. 12; NSW 2; SA 3; Tas. 1; QL 2; WA 4).
Results: 2546 interactions (1582 face-to-face; 398 email; 216 telephone; 20 SMS; 47 Skype; 55 >1 modality of remote contact; 226 administrative; 2 other) were documented for 896 Type 1 diabetes patients (32% M), mean (SD) age 35.4 (14.2) Y, over 11.9 (6.3) [mean (SD)] wks.
Mean (range) face-to-face IPT interactions and median (range) time spent per patient (pt).
x = number of interactions, n=number of patients
21 new IPT starts were tracked to stabilisation from 9 centres. Total time per patient spent with nurse was 758 min/ 12.6 hours, with doctor 122 min/ 2 hours and with dietician 175 min/ 2.9 hours.
Conclusions: IPT patient care represents a substantial investment in HCP time. 29% of interactions were remote, and unlikely to have generated income. This is not sustainable under the current Australian system especially in the setting of increased IPT usage. Review of funding for IPT care is needed urgently.