title: Impact of continuous glucose monitoring on quality of life, treatment satisfaction, and use of medical care resources: analyses from the SWITCH study.
abstract: To investigate the impact of continuous glucose monitoring (CGM) on health-related quality of life (HRQOL), treatment satisfaction (TS) medical resource use, and indirect costs in the SWITCH study. SWITCH was a multicentre, randomized, crossover study. Patients with type 1 diabetes (n = 153) using continuous subcutaneous insulin infusion (CSII) were randomized to a 12 month sensor-On/Off or sensor-Off/On sequence (6 months each treatment), with a 4-month washout between periods. HRQOL in children and TS in adults were measured using validated questionnaires. Medical resource utilization data were collected. In adults, TS was significantly higher in the sensor-On arm, and there were significant improvements in ratings for treatment convenience and flexibility. There were no clinically significant differences in children's HRQOL or parents' proxy ratings. The incidence of severe hypoglycaemia, unscheduled visits, or diabetes-related hospitalizations did not differ significantly between the two arms. Adult patients made fewer telephone consultations during the sensor-On arm; children's caregivers made similar numbers of telephone consultations during both arms, and calls were on average only 3 min longer during the sensor-On arm. Regarding indirect costs, children with >70 % sensor usage missed fewer school days, compared with the sensor-Off arm (P = 0.0046) but there was no significant difference in the adults days of work off. The addition of CGM to CSII resulted in better metabolic control without imposing an additional burden on the patient or increased medical resource use, and offered the potential for cost offsets.
authors.affiliation: Steno Diabetes Center, Niels Steensensvej 2, 2820, Gentofte, Copenhagen, Denmark, evho@steno.dk.
authors.forename: E
authors.initials: E
authors.lastname: Hommel
authors.forename: B
authors.initials: B
authors.lastname: Olsen
authors.forename: T
authors.initials: T
authors.lastname: Battelino
authors.forename: I
authors.initials: I
authors.lastname: Conget
authors.forename: I
authors.initials: I
authors.lastname: Schütz-Fuhrmann
authors.forename: R
authors.initials: R
authors.lastname: Hoogma
authors.forename: U
authors.initials: U
authors.lastname: Schierloh
authors.forename: N
authors.initials: N
authors.lastname: Sulli
authors.forename: H
authors.initials: H
authors.lastname: Gough
authors.forename: J
authors.initials: J
authors.lastname: Castañeda
authors.forename: S
authors.initials: S
authors.lastname: de Portu
authors.forename: J
authors.initials: J
authors.lastname: Bolinder
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring / Q000191:economics / Q000523:psychology*; D002648:Child; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy* / Q000191:economics / Q000523:psychology; D006442:Glycated Hemoglobin / Q000378:metabolism; D017048:Health Care Costs; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007328:Insulin / Q000008:administration & dosage; D007332:Insulin Infusion Systems / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011788:Quality of Life; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human