Patient Time Costs Associated with Sensor-Augmented Insulin Pump Therapy for Type 1 Diabetes

Shital Kamble, Kevin P. Weinfurt, Kevin A. Schulman and Shelby D. Reed

Medical Decision Making, 2013, vol. 33, issue 2, 215-224

Abstract: Background . Sensor-augmented pump therapy (SAPT) leads to lower glycated hemoglobin levels than multiple daily injections of insulin (MDI) in patients with type 1 diabetes. Patient time and costs associated with SAPT are not known. Objective . We compared time spent on diabetes-related care, changes in time, and associated patient time costs between patients randomly assigned to SAPT or MDI. Design, Setting, and Participants . During a 52-week clinical trial, participants aged 7 to 70 years (n = 483) reported total time per week spent on diabetes-related care. Measurements . Patient time, including comparisons during pump initiation, 52-week patient time costs, and changes in weekly time estimates after pump initiation. Results . At baseline, patients in the MDI group reported spending an average of 4.0 hours per week on diabetes-related care. During the pump initiation period (weeks 1–7), SAPT patients spent 1.9 hours more per week than MDI patients (95% confidence interval [CI], 1.2–2.6). After the initiation period (weeks 8–52), SAPT patients spent 1 hour more per week (95% CI, 0.4–1.7) than MDI patients (i.e., 4.4 v. 3.4 hours); patients in both groups spent progressively less time on diabetes-related care by 1.2 minutes per week (95% CI, −1.7 to −0.7). Overall, mean time costs per person were $4600 with the SAPT group and $3523 with the MDI group (difference, $1077; 95% CI, $491–$1638). Limitations . Time spent on specific activities was not collected, and the estimates do not explicitly account for caregiver time associated with diabetes care activities. Conclusions . Patients receiving SAPT v. MDI spent approximately 2 hours more per week on diabetes-related care during pump initiation and 1 hour more per week thereafter, resulting in higher patient time costs.

Keywords: shared decision making; decision aids—tools; physician-patient communication; judgment and decision psychology; cohort studies; clinical research methodology (search for similar items in EconPapers)
Date: 2013
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:33:y:2013:i:2:p:215-224

DOI: 10.1177/0272989X12464824

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