‘You've got something to look at and something to achieve’ : Perspectives of adults with type 2 diabetes on professional‐mode glucose monitoring. A GP ‐ OSMOTIC nested qualitative study

AIMS: Approximately half of adults with type 2 diabetes (T2D) have average glucose levels above the recommended range, increasing the risk of long-term complications. Intermittent (quarterly) use of professional-mode continuous glucose monitoring (Pro-CGM) offers opportunity for greater personalisation of management, collaborative care and targeted education to support behavioural modification. Framed in Self-Determination Theory (SDT), this study aimed to explore how Pro-CGM was experienced by adults with T2D, and to identify potential mechanisms for behaviour change. METHODS: This qualitative study was nested within a pragmatic, 12-month randomised controlled trial of quarterly Pro-CGM in primary care. Participants were purposively recruited from the intervention group; 22 individuals from six primary care clinics in Victoria, Australia, took part. An abductive analytic approach was adopted, whereby data-driven themes were subsequently interpreted through the SDT framework. RESULTS: Qualitative analyses identified Pro-CGM monitoring and consultation experiences both satisfied and frustrated individual needs. Impacts on motivation and behaviour change were influenced by the degree to which support needs were met by clinicians and individual differences (e.g. regulatory orientation, preferences). This suggests that more sustained changes in behaviour and longer-term improvements in HbA1c may have occurred if Pro-CGM was implemented in a manner that provided appropriate support for psychological needs. CONCLUSION: Pro-CGM has the potential to improve engagement in diabetes self management and health outcomes among people with T2D. Consideration of Pro-CGM-related resource needs for people with T2D, including facilitation of clinical support, is required to optimise the engagement with and sustain behavioural change for people with T2D.