Introduction & Objective: CGM is associated with better clinical and psychosocial outcomes. While expanding, CGM is limited in primary care (PC), where most diabetes care occurs and where NPs are often crucial. We identified NP and practice factors associated with CGM-related behaviors, attitudes, and needs to understand how to support CGM use by NPs in PC.

Methods: Cross-sectional survey; multivariable linear and logistic regression. N=200 NPs in PC, recruited through the American Association of Nurse Practitioners. Outcome: CGM use. Independent variables: NP characteristics (eg, years since training, full- or part-time status) and practice setting (eg, organization type, payer mix).

Results: Most participants practiced family (67%) or internal medicine (28%). Practices included private (34%), hospital-owned (29%), and FQHC (20%). 44% had prescribed CGM. Primary outcome: Compared to private practice, hospital-owned practice NPs were more likely to have prescribed CGM (OR 2.32, 95% CI: 1.09-4.90, p<.01); academic medical center NPs were less likely to have prescribed (OR .098, 95% CI: .012-.799, p<.01). Secondary outcomes: Predictors of favorability toward future CGM prescribing were past CGM prescribing (coef = .73, p<.0001) and time since training (1-5 years: coef = -.48, 6-15 years: coef = -.41; p<.01). Predictors of confidence using CGM in diabetes care were prior CGM prescribing (T1D coef = 3.57, T2D coef = 3.49; p<.0001) and having >50% Medicare patients (T1D coef = 1.77; T2D coef = 2.04, p<.01). NPs identified a one-time endocrine consult (62%), CGM education website (61%), and asynchronous endocrine e-consult (59%) as resources that would make them moderately/very likely to prescribe CGM.

Conclusion: Targeting academic medical centers, private practice, and NPs who serve mostly non-Medicare patients, as well as consults and education resources, could help PC NPs bring CGM to more people with diabetes.

Disclosure

T. Hall: None. L. Dickinson: None. M.K. Warman: None. T. Oser: Research Support; Abbott. Advisory Panel; Medscape. Consultant; Dexcom, Inc. Research Support; Insulet Corporation. S. Oser: Other Relationship; American Diabetes Association, Association of Diabetes Care & Education Specialists. Research Support; Abbott. Advisory Panel; Dexcom, Inc., Jaeb Center for Health Research.

© 2024 by the American Diabetes Association
2024
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