Background: CGM use is associated with improved outcomes in T1D, but racial-ethnic disparities in prescribing exist. We examined whether diabetes practice transformations could change prescribing behaviors to improve CGM prescription rates.
Methods: From January 2019 to December 2021, our diabetes center underwent a practice transformation targeted towards equity that included hiring clinicians to develop a specialty T1D clinic; training support staff to place trial devices at the point of care; improving prescribing workflows; and educating providers on CGM and inequity in practices. To examine effect, we collected monthly aggregate data from the electronic medical record and measured CGM prescription rates. We performed linear regression to examine change in prescriptions over time.
Results: We included 1,357 adults with T1D [mean age 38 years (±18) , 45% Hispanic (n=612) , 30% non-Hispanic Black (n=406) , 12% non-Hispanic White (n=164) ; and 74% publicly insured]. Over the practice transformation period, CGM prescription rates quadrupled (p<0.001) with the largest improvement in non-Hispanic Black and Hispanic groups (Figure 1) .
Conclusions: Diabetes practice transformations can change prescribing behaviors to improve equity in CGM. Continued focus is needed on upstream interventions that effect downstream determinants of CGM use.
P. M. Mathias: None. L. Mahali: None. S. Agarwal: Advisory Panel; Medtronic, Consultant; Beta Bionics, Inc.
Helmsley Charitable Trust (T1D Exchange Quality Improvement Collaborative)