Outcomes of a virtual CGM initiation service (virCIS) for primary care patients with diabetes

<h3>Context:</h3> Continuous glucose monitoring (CGM) is now considered a standard treatment option in diabetes care. However, its adoption has been slower in primary care settings compared to endocrinology practices, resulting in unequal access for patients with diabetes. Implementation of a virtual CGM initiation service can be valuable for enhancing CGM access to primary care patients with diabetes. <h3>Objective:</h3> Assess the feasibility of implementing a virtual CGM initiation service (virCIS) for primary care patients with diabetes. <h3>Study Design and Analysis:</h3> virCIS was a non-randomized arm that was part of a larger cluster randomized trial. <h3>Setting:</h3> Primary care practices in Colorado. <h3>Population studied:</h3> Patients with diabetes referred by practices enrolled in virCIS. <h3>Intervention:</h3> Primary care providers were invited to attend a webinar that focused on identifying patients who may benefit from CGM use, best practices for prescribing, and CGM interpretation. Practices referred patients to virCIS for CGM initiation and management for 6 months. Patients attended a virtual CGM initiation visit and three 1-on-1 interpretation visits with a diabetes care and education specialist and pharmacist, completed on Zoom. Patients were provided a CGM, received education on medication, diet and exercise, and completed surveys at baseline, 3, 6, and 12 months. <h3>Outcome Measures:</h3> Number of practices enrolled, patients referred and enrolled, and completed study visits. Secondary outcomes include practice characteristics, patient demographics, and patient satisfaction. <h3>Results:</h3> 23 practices enrolled in virCIS (21 referred patients; 19 had patients enroll in the study). Most practices were clinician owned solo or group practice (n=13), followed by hospital or health system owned (n=6). Two practices were FQHCs. 145 patients were referred and 73 patients enrolled in the study (~50% enrollment rate). 61 patients completed a virtual CGM initiation visit and 50 completed at least one interpretation visit. Patients will complete all visits by August 2024 and completed patient data, including satisfaction data, will be presented. <h3>Conclusions:</h3> Practice improvement through provider education and implementation of a virtual CGM initiation service can lead to improved diabetes care for patients, through initiation and interpretation of CGM. Lessons learned from this service may aid in the creation of a toolkit to support the replication of the virtual CGM service in other primary care settings.