Study Finds Limited Knowledge of HCPs Can Hinder Use of Open Source-AID Technology

This new survey from the UK assessed the perceptions of healthcare professionals (HCPs) and the implementation of practices focused on open source automated insulin delivery (OS-AID).

Results of a survey conducted in the UK from February to April 2019 revealed that although healthcare professionals (HCPs) are aware of the benefits of open source automated insulin delivery (OS-AID) for children and adults with type 1 diabetes, and would support patients who choose to use it, few are confident in both their overall knowledge of the technology and their knowledge of its regulations and do not discuss the option potential treatment accordingly.

The results were recently published in Diabetes therapy, and they also revealed that 43% of healthcare professionals surveyed were concerned that the use of OS-AID could introduce a risk of adverse effects if it got “into the wrong hands”. Their survey was distributed through the Association of British Clinical Diabetologists Diabetes Technology Network UK and the Association of Children’s Diabetes Clinicians (ACDC). Questions could be answered on a Likert scale of 1 to 5, in a yes/no manner, or via multiple choice, which contained an option to write your own answer.

“OS-AID systems have been extensively described in other articles and their adoption by the diabetes community has grown steadily over the past few years. [However,] they remain unapproved at this time,” the study authors wrote. “Given the complexity of issues related to OS-AID systems from a clinical, regulatory and ethical perspective, the objective of this work was to establish the prevailing opinions and perceptions of healthcare professionals and their approaches users of these systems in daily practice.”

Of the 317 responses received, few responded that they were “extremely confident” that they could adequately describe how to implement OS-AID (8.8%). On the contrary, a majority (73.5%) were “fairly confident” or less, as indicated by a score of 3 or more on the Likert scale. Only 5 of the “extremely confident” respondents came from practices where 5 or more patients were already using an OS-AID.

Similar trends were seen when examining the risks and benefits, respectively, of OS-AID systems: most – 77.9% and 81.4% – were “somewhat confident” or less confident they could treat them. appropriately with their patients. Only 3.7% and 5.3%, respectively, chose “extremely confident”.

Consultants were found to be the most confident (P

The total number of insulin pump and OS-AID users in a ward was also likely a comfort level factor. Pairwise comparisons demonstrated that respondents from practices with less than 2 OS-AID users were less confident than respondents from practices with 2-5 or 6-10 users. Respondents from pump centers with 0 to 100 users were less confident than those from centers with more than 500 insulin pump users.

Nearly 91% chose a multiple-choice response for their attitudes toward OS-AID systems and their current practice, with the majority again stating that they were not comfortable providing ongoing support (59.0 %). Only 5% felt “extremely comfortable”. Most (91%) also said they were not even comfortable engaging in discussions about OS-AID systems, with common reasons being that they were still not approved (67%) , had limited knowledge (63%), feared for their professional reputation (31.8%), and did not want to invalidate a pump warranty provided by the National Health Service (28%).

Despite the numbers above, 94% said they would continue to provide ongoing care; of those who said they were unable to provide care, their main reason was that they felt unable to advise on system management. Additionally, 96.5% expressed their belief that healthcare professionals should learn more about OS-AID and 95.9% said they wanted to learn more themselves.


Crabtree TSJ, Choudhary P, Lumb A, et al. Association of British Clinical Diabetologists, Diabetes Technology Network UK and Association of Children’s Diabetes Clinicians survey of UK healthcare professionals’ attitudes towards open source automated insulin delivery systems. Diabetes Ther. 2022;13(2):341-353. doi:10.1007/s13300-022-01203-5

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