Capability, opportunity and motivation to support adults with type 1 diabetes experiencing fear of hypoglycaemia: A survey of Australian diabetes healthcare professionals

AIM: To explore the perceptions, experiences and unmet needs of diabetes healthcare professionals (DHPs) for supporting adults with type 1 diabetes (T1D) with fear of hypoglycaemia (FoH). METHOD: An online survey explored Australian DHPs' perceived capability, opportunity, motivation and behaviours related to supporting adults with T1D with FoH. DHPs were recruited via online advertisements, e-newsletters and at conferences. Quantitative data were analysed using descriptive statistics, and qualitative data were analysed thematically. RESULTS: A total of 106 eligible DHPs were included (83% credentialled diabetes educators, 92% women, mean (SD) age 49 (11) years), from all eight states/territories. DHPs indicated that FoH is experienced by almost two thirds of adults with T1D in their clinics. Most DHPs believe addressing FoH is within their scope of clinical practice (83%), and report motivation (89%) and capability (skills and confidence, 71% and 70% respectively) to do so. While more than half (50%-71%) perceive they have the social opportunity (e.g. social norms, workplace culture), few report physical opportunity (8%-24%), for example, access to validated screening tools; financial remuneration; affordable mental healthcare referral pathways. Free-text responses highlighted the need for affordable and timely access to mental health professionals with knowledge about diabetes. Approximately eight out of ten would be (very) likely to refer those experiencing FoH to online self-guided programs, if available. CONCLUSION: These findings show that Australian DHPs report the motivation and capability, but lack the opportunity to support adults with T1D experiencing FoH. Innovative referral pathways, including online self-guided programmes, are perceived positively and may be useful in the Australian healthcare context.