Primary Care Clinicians Can Embrace CGM Implementation With Support, Study Finds

Primary care practices may benefit from offering continuous glucose monitoring (CGM) to their patients with diabetes as coverage for these devices expands, and education surrounding diabetes care and CGM will be crucial, according to a study published in Annals of Family Medicine.

Researchers used a cross sectional web-based survey, which revealed that most clinicians embrace CGM in their practices, but may lack the resources or training needed to feel comfortable enough to implement CGM. The survey also found that clinicians who were located more than 40 miles from an endocrinologist were more likely to prescribe CGM to patients and were more likely to prescribe CGM in the future to those less than 10 miles from an endocrinologist.

Additionally, clinicians with more Medicare patients had favorable attitudes toward prescribing CGM and CGM technologies, suggesting a need for health insurance coverage policy to increase the use of CGM in primary care. Furthermore, the researchers found that both expanded insurance coverage and CGM training were the most needed resources to support the use of CGM in standard primary care practices.

“These findings indicate that primary care clinicians are open to using CGM to help their patients with diabetes, but they need resources and support,” the authors wrote. “Past experience prescribing CGM was strongly associated with favorability toward prescribing CGM in the future.”

Of a total of 656 respondents who completed the survey, 24 were excluded, leaving 632 respondents who were included in the data analysis for this study. The majority of respondents specialized in family medicine, with about one-half of respondents located in the western region of the United States.

The survey revealed that 46.6% of respondents had seen patients with a CGM but never prescribed CGM, 38.6% had ever prescribed a CGM, and 1% had never heard of CGM.

Most (89.5%) respondents reported that they were at least somewhat likely to prescribe CGM in the future.

Those who had prescribed CGM before were 7 times more likely to prescribe CGM in the future.

“This suggests that once primary care physicians and advanced practice clinicians overcome the challenge of learning to prescribe and use CGM to manage diabetes, they are likely to continue doing it,” wrote the researchers.

Additionally, working in a care setting with more than half of patients having Medicare coverage also increased the likelihood of prescribing CGM in the future, compared with care settings with less than 25% of patients covered by Medicare.

Most of the respondents reported that they would be moderately or very likely to prescribe CGM if they received CGM training workshops (72.3%) or CGM consultation on insurance issues (72.0%).

The researchers wrote that additional studies are needed to better understand how more patients with diabetes may benefit from CGM.

They also acknowledged limitations to this survey, including the fact that the survey and study did not include barriers to prescribing CGM, nor did it address resources needed to support CGM training and CGM awareness education.

In order to implement CGM into primary care and become a standard of practice, the authors concluded, greater training about CGM needs to be introduced into primary care.

Reference

Oser TK, Hall TL, Dickinson LM, et al. Continuous glucose monitoring in primary care: understanding and supporting clinicians' use to enhance diabetes care. Ann Fam Med. 2022;20(6):541-547. doi:10.1370/afm.2876