Trial Outcomes & Findings for Evaluation of Satisfaction Regarding Home Healthcare Provider (HHP) Management of Type 1 Diabetic Patients Using a Closed-loop Automatic Insulin Delivery System (NCT NCT04635280)

NCT ID: NCT04635280

Last Updated: 2024-10-15

Results Overview

Satisfaction regarding the management in general was assessed using the Client Satisfaction Questionnaire (CSQ-8). CSQ-8 is a validated questionnaire that measures patients' overall satisfaction with their management in general. It contains 8 questions and each question is answered using a 4-point scale. The score ranges from 8 to 32, with higher values indicating higher satisfaction. Patients were considered as satisfied if they reached a score above 20 points.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

35 participants

Primary outcome timeframe

Day 30 and Day 90

Results posted on

2024-10-15

Participant Flow

A total of 35 patients were enrolled from 2 french centres. First Patient Enrolled: 10 May 2021 Last patient Enrolled: 22 September 2021 Last Patient Completed: 12 January 2022

Participant milestones

Participant milestones
Measure
Hybrid Closed-loop Automatic Insulin Delivery System
A closed-loop automatic insulin delivery system includes a combination of an insulin pump, a continuous glucose monitoring system and an algorithm.
Overall Study
STARTED
35
Overall Study
COMPLETED
35
Overall Study
NOT COMPLETED
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Hybrid Closed-loop Automatic Insulin Delivery System
n=35 Participants
A closed-loop automatic insulin delivery system includes a combination of an insulin pump, a continuous glucose monitoring system and an algorithm.
Age, Continuous
42.4 years
STANDARD_DEVIATION 11.5 • n=35 Participants
Sex: Female, Male
Female
14 Participants
n=35 Participants
Sex: Female, Male
Male
21 Participants
n=35 Participants
Region of Enrollment
France
35 participants
n=35 Participants
HbA1c in category
<7%
10 Participants
n=35 Participants
HbA1c in category
7%-<8%
18 Participants
n=35 Participants
HbA1c in category
8%-10%
7 Participants
n=35 Participants
HbA1c
7.35 percentage of glycated hemoglobin
STANDARD_DEVIATION 0.77 • n=35 Participants
Time since type 1 diabetes diagnosis
23.3 years
STANDARD_DEVIATION 12.4 • n=35 Participants

PRIMARY outcome

Timeframe: Day 30 and Day 90

Population: Intention-To-Treat (ITT) population: all included patients fitted with the device who met all of the inclusion and exclusion criteria

Satisfaction regarding the management in general was assessed using the Client Satisfaction Questionnaire (CSQ-8). CSQ-8 is a validated questionnaire that measures patients' overall satisfaction with their management in general. It contains 8 questions and each question is answered using a 4-point scale. The score ranges from 8 to 32, with higher values indicating higher satisfaction. Patients were considered as satisfied if they reached a score above 20 points.

Outcome measures

Outcome measures
Measure
Hybrid Closed-loop Automatic Insulin Delivery System
n=35 Participants
A closed-loop automatic insulin delivery system includes a combination of an insulin pump, a continuous glucose monitoring system and an algorithm.
Number of Participants With Satisfaction Regarding the Management in General, at Day 30 and Day 90, by the CSQ-8 Questionnaire
Patients satisfied - Day 30
35 Participants
Number of Participants With Satisfaction Regarding the Management in General, at Day 30 and Day 90, by the CSQ-8 Questionnaire
Patients satisfied - Day 90
35 Participants

PRIMARY outcome

Timeframe: Day 90

Population: ITT population: all included patients fitted with the device who met all of the inclusion and exclusion criteria

Satisfaction regarding the management in general was assessed using the Client Satisfaction Questionnaire (CSQ-8). CSQ-8 is a validated questionnaire that measures patients' overall satisfaction with their management in general. It contains 8 questions and each question is answered using a 4-point scale. The score ranges from 8 to 32, with higher values indicating higher satisfaction. Satisfaction was defined by a score above 20 points. Maintenance of satisfaction is measured on D90 by a score above 20 points which has not decreased by more than 4 points compared with D30.

Outcome measures

Outcome measures
Measure
Hybrid Closed-loop Automatic Insulin Delivery System
n=35 Participants
A closed-loop automatic insulin delivery system includes a combination of an insulin pump, a continuous glucose monitoring system and an algorithm.
Number of Participants With Maintenance of Global Patient Satisfaction Regarding the Management in General, at Day 90, by the CSQ-8 Questionnaire
Satisfaction maintained
33 Participants
Number of Participants With Maintenance of Global Patient Satisfaction Regarding the Management in General, at Day 90, by the CSQ-8 Questionnaire
Satisfaction not maintained
2 Participants

PRIMARY outcome

Timeframe: Day 30 and Day 90

Population: ITT population: all included patients fitted with the device who met all of the inclusion and exclusion criteria All participants completed at least partially the questionnaire; 27 participants completed entirely the questionnaire at D30 and 30 participants completed entirely the questionnaire at D90; 31 participants completed entirely the questionnaire at either D30 or D90.

The questionnaire was developed for the study by the French Diabetes Federation, aiming at evaluating patient satisfaction and experience with their management by the HHP. 16 questions assessed the proactiveness, availability and HHP nurse advice. A global score ranging from 13 to 57 was calculated, with higher values indicating higher satisfaction. The global score was only calculated when all questions were answered.

Outcome measures

Outcome measures
Measure
Hybrid Closed-loop Automatic Insulin Delivery System
n=31 Participants
A closed-loop automatic insulin delivery system includes a combination of an insulin pump, a continuous glucose monitoring system and an algorithm.
Description of Patient Satisfaction and Experience Regarding the Management by HHP at Day 30 and Day 90
Day 30
47.6 units on a scale
Standard Deviation 5.2
Description of Patient Satisfaction and Experience Regarding the Management by HHP at Day 30 and Day 90
Day 90
46.8 units on a scale
Standard Deviation 5.3

SECONDARY outcome

Timeframe: Throughout the study, up to 3 months

Population: ITT population: all included patients fitted with the device who met all of the inclusion and exclusion criteria

Cumulative number of HHP interactions during the study, in total and by type of contact. Unplanned additional contacts are included.

Outcome measures

Outcome measures
Measure
Hybrid Closed-loop Automatic Insulin Delivery System
n=35 Participants
A closed-loop automatic insulin delivery system includes a combination of an insulin pump, a continuous glucose monitoring system and an algorithm.
Total Number of HHP Interactions
Total number of contacts
7.3 number of contacts
Standard Deviation 1.5
Total Number of HHP Interactions
Phone contacts
2.8 number of contacts
Standard Deviation 1.5
Total Number of HHP Interactions
Physical visits contacts
3.8 number of contacts
Standard Deviation 1.1

SECONDARY outcome

Timeframe: Throughout the study, up to 3 months

Population: ITT population: all included patients fitted with the device who met all of the inclusion and exclusion criteria

Cumulative duration of HHP interactions during the study, for all contacts and by type of contact

Outcome measures

Outcome measures
Measure
Hybrid Closed-loop Automatic Insulin Delivery System
n=35 Participants
A closed-loop automatic insulin delivery system includes a combination of an insulin pump, a continuous glucose monitoring system and an algorithm.
Cumulative Duration of HHP Interactions
All contacts
472 minutes
Standard Deviation 123
Cumulative Duration of HHP Interactions
Phone contacts
66 minutes
Standard Deviation 47
Cumulative Duration of HHP Interactions
Physical visits contacts
329 minutes
Standard Deviation 97

SECONDARY outcome

Timeframe: Throughout the study, up to 3 months

Population: ITT population: all included patients fitted with the device who met all of the inclusion and exclusion criteria

Number and percentage of patients who required increased follow-up/support, identical follow-up/support and reduced follow-up/ support in relation to what was recommended in the supplier's information record. The maximal number of contacts expected in the supplier's information record was 9 contacts.

Outcome measures

Outcome measures
Measure
Hybrid Closed-loop Automatic Insulin Delivery System
n=35 Participants
A closed-loop automatic insulin delivery system includes a combination of an insulin pump, a continuous glucose monitoring system and an algorithm.
Comparison of the HHP Observed Management With the Theoretical Management Described in the Medical Device's Information Record.
Reduced (< 9 contacts)
29 Participants
Comparison of the HHP Observed Management With the Theoretical Management Described in the Medical Device's Information Record.
Identical (=9 contacts)
4 Participants
Comparison of the HHP Observed Management With the Theoretical Management Described in the Medical Device's Information Record.
Increased (>9 contacts)
2 Participants

SECONDARY outcome

Timeframe: At inclusion, Day 30 and Day 90

Population: ITT population: all included patients fitted with the device who met all of the inclusion and exclusion criteria

The patient's quality of life was assessed by the quality of life questionnaire (EQ-5D-5L), validated in French Language. It is composed of 5 items each corresponding to a specific dimension (mobility, self-care, usual activities, pain/discomfort and anxiety/depression) and divided into 5 levels of perception (1. no problem, 2. slight problems, 3. moderate problems, 4. severe problems, 5. extreme problems/incapacity). The digits for the 5 dimensions were combined in a 5-digit code describing the patient's health state and were converted into a summary index value using the french value sets. The summary index ranges between 0 (dead) and 1 (perfect health)

Outcome measures

Outcome measures
Measure
Hybrid Closed-loop Automatic Insulin Delivery System
n=35 Participants
A closed-loop automatic insulin delivery system includes a combination of an insulin pump, a continuous glucose monitoring system and an algorithm.
Quality of Life Questionnaire (EQ-5D) Summary Index at Inclusion, Day 30 and Day 90
Inclusion
0.95 units on a scale
Standard Deviation 0.10
Quality of Life Questionnaire (EQ-5D) Summary Index at Inclusion, Day 30 and Day 90
Day 30
0.94 units on a scale
Standard Deviation 0.09
Quality of Life Questionnaire (EQ-5D) Summary Index at Inclusion, Day 30 and Day 90
Day 90
0.94 units on a scale
Standard Deviation 0.10

SECONDARY outcome

Timeframe: At inclusion, Day 30 and Day 90.

Population: ITT population: all included patients fitted with the device who met all of the inclusion and exclusion criteria

The HFS-II is a validated questionnaire that will be used to measure quality of life and daily constraints with respect to hypoglycaemia-related behaviours and concerns in adults with type 1 diabetes. The HFS total score ranges from 0 to 132, with higher values indicating a higher fear of hypoglycemia.

Outcome measures

Outcome measures
Measure
Hybrid Closed-loop Automatic Insulin Delivery System
n=35 Participants
A closed-loop automatic insulin delivery system includes a combination of an insulin pump, a continuous glucose monitoring system and an algorithm.
Hypoglycaemia Fear Survey (HFS) Total Score at Inclusion, Day 30 and Day 90
Inclusion
31.2 score on a scale
Standard Deviation 15.7
Hypoglycaemia Fear Survey (HFS) Total Score at Inclusion, Day 30 and Day 90
Day 30
25.7 score on a scale
Standard Deviation 20.1
Hypoglycaemia Fear Survey (HFS) Total Score at Inclusion, Day 30 and Day 90
Day 90
23.1 score on a scale
Standard Deviation 16.8

SECONDARY outcome

Timeframe: At inclusion, Day 30 and Day 90

Population: ITT population: all included patients fitted with the device who met all of the inclusion and exclusion criteria

The patient's everyday constraints were assessed based on the past month, with a questionnaire in the form of a pre-established multiple-choice list. The questionnaire was developed by the French Diabetes Federation and includes 12 items: - Managing other people's perceptions of my diabetes - Anticipating my activities - Thinking about my diabetes all the time - Dealing with my diabetes all the time - Fear of experiencing hypoglycaemia - Fear of experiencing hyperglycaemia - Uncertainties about my future health - Carrying one or more treatment devices on me at all times - Handling my continuous glucose sensor - Handling all my treatment equipment (pump, glucose sensor, etc.) - Determining my insulin doses several times a day - Hearing the audible alarms of my treatment equipment (pump, glucose sensor, etc.). The number of constraints is reported.

Outcome measures

Outcome measures
Measure
Hybrid Closed-loop Automatic Insulin Delivery System
n=35 Participants
A closed-loop automatic insulin delivery system includes a combination of an insulin pump, a continuous glucose monitoring system and an algorithm.
Number of Daily Constraints Encountered by Patients on the Past Month at Inclusion, Day 30 and Day 90
Inclusion
3.4 number of constraints ticked
Standard Deviation 1.8
Number of Daily Constraints Encountered by Patients on the Past Month at Inclusion, Day 30 and Day 90
Day 30
2.5 number of constraints ticked
Standard Deviation 1.2
Number of Daily Constraints Encountered by Patients on the Past Month at Inclusion, Day 30 and Day 90
Day 90
2.9 number of constraints ticked
Standard Deviation 1.8

SECONDARY outcome

Timeframe: At inclusion and Day 90

Population: ITT population: all included patients fitted with the device who met all of the inclusion and exclusion criteria

The expected and perceived benefits with respect to the closed-loop automated insulin delivery system was assessed by the questionnaire "You and the Hybrid Closed-Loop (HCL) automated insulin delivery system" developed by the French Diabetes Federation for the study. Only 2 benefits are presented

Outcome measures

Outcome measures
Measure
Hybrid Closed-loop Automatic Insulin Delivery System
n=35 Participants
A closed-loop automatic insulin delivery system includes a combination of an insulin pump, a continuous glucose monitoring system and an algorithm.
Number of Participants Who Expected and Perceived Benefits With Respect to the Closed-loop Automated Insulin Delivery System at Inclusion and Day 90
Expected experiencing less hypo/ hyperglycemia at Inclusion
35 Participants
Number of Participants Who Expected and Perceived Benefits With Respect to the Closed-loop Automated Insulin Delivery System at Inclusion and Day 90
Noticed less hypo/ hyperglycemia at D90
31 Participants
Number of Participants Who Expected and Perceived Benefits With Respect to the Closed-loop Automated Insulin Delivery System at Inclusion and Day 90
Expected spending more time in glycemic target at inclusion
34 Participants
Number of Participants Who Expected and Perceived Benefits With Respect to the Closed-loop Automated Insulin Delivery System at Inclusion and Day 90
Noticed spending more time in glycemic target at D90
32 Participants

SECONDARY outcome

Timeframe: At inclusion and Day 90

Population: ITT population: all included patients fitted with the device who met all of the inclusion and exclusion criteria.

The patient's beliefs about the medical treatment were assessed by the specific section of the BMQ (Beliefs about Medicines Questionnaire), validated in French for diabetes. The specific BMQ consists of two parts: Part one contains five questions related to the need for the treatment and part two contains five questions on concerns about the prescription. The 10 questions are answered using a 5-point scale (1. strongly disagree, 2. disagree, 3. uncertain, 4. agree and 5. strongly agree). The results take the form of two scores ranging from 5 to 25, with higher value indicating higher need/concerns for treatment.

Outcome measures

Outcome measures
Measure
Hybrid Closed-loop Automatic Insulin Delivery System
n=35 Participants
A closed-loop automatic insulin delivery system includes a combination of an insulin pump, a continuous glucose monitoring system and an algorithm.
Beliefs About Medicines Questionnaire (BMQ) Scores at Inclusion and D90
BMQ - higher need score at Inclusion
19.5 units on a scale
Standard Deviation 2.3
Beliefs About Medicines Questionnaire (BMQ) Scores at Inclusion and D90
BMQ - higher need score at D90
19.1 units on a scale
Standard Deviation 2.1
Beliefs About Medicines Questionnaire (BMQ) Scores at Inclusion and D90
BMQ - concerns score at Inclusion
15.9 units on a scale
Standard Deviation 2.3
Beliefs About Medicines Questionnaire (BMQ) Scores at Inclusion and D90
BMQ - concerns score at D90
15.8 units on a scale
Standard Deviation 2.3

SECONDARY outcome

Timeframe: Inclusion and Day 90

Population: ITT population: all included patients fitted with the device who met all of the inclusion and exclusion criteria

HbA1c (%) at inclusion and Day 90

Outcome measures

Outcome measures
Measure
Hybrid Closed-loop Automatic Insulin Delivery System
n=35 Participants
A closed-loop automatic insulin delivery system includes a combination of an insulin pump, a continuous glucose monitoring system and an algorithm.
HbA1c at Inclusion and Day 90
Hba1c at Inclusion
7.35 percentage of glycated hemoglobin
Standard Deviation 0.77
HbA1c at Inclusion and Day 90
Hba1c at Day 90
6.68 percentage of glycated hemoglobin
Standard Deviation 0.63
HbA1c at Inclusion and Day 90
Absolute change of HbA1c at D90 from inclusion
-0.67 percentage of glycated hemoglobin
Standard Deviation 0.42

SECONDARY outcome

Timeframe: At inclusion and Day 90

Population: ITT population: all included patients fitted with the device who met all of the inclusion and exclusion criteria

Glycemic variability assessed by the coefficient of variation (CV)

Outcome measures

Outcome measures
Measure
Hybrid Closed-loop Automatic Insulin Delivery System
n=35 Participants
A closed-loop automatic insulin delivery system includes a combination of an insulin pump, a continuous glucose monitoring system and an algorithm.
Glycemic Variability at Inclusion and Day 90
Glycemic CV at Inclusion
38.7 percentage of coefficient of variation
Standard Deviation 5.8
Glycemic Variability at Inclusion and Day 90
Glycemic CV at Day D90
34.1 percentage of coefficient of variation
Standard Deviation 5.0
Glycemic Variability at Inclusion and Day 90
Absolute change of Glycemic CV at D90 from installation
-4.2 percentage of coefficient of variation
Standard Deviation 4.5

SECONDARY outcome

Timeframe: At inclusion and Day 90

Population: ITT population: all included patients fitted with the device who met all of the inclusion and exclusion criteria

Percentage of time spent over a 4-week period in glycemic target range, in hypoglycaemia and in hyperglycaemia. Glycemic target range: 70-180 mg/dl, hypoglycaemia: \< 70 mg/dl and hyperglycaemia :\> 180 mg/dl

Outcome measures

Outcome measures
Measure
Hybrid Closed-loop Automatic Insulin Delivery System
n=35 Participants
A closed-loop automatic insulin delivery system includes a combination of an insulin pump, a continuous glucose monitoring system and an algorithm.
Percentage of Time Spent Over a 4-week Period in Glycemic Target Range at Inclusion and Day 90
Time in range 70-180 mg/dl at inclusion
57.0 percentage of time
Standard Deviation 13.3
Percentage of Time Spent Over a 4-week Period in Glycemic Target Range at Inclusion and Day 90
Time in range 70-180 mg/dl at D90
71.4 percentage of time
Standard Deviation 9.4
Percentage of Time Spent Over a 4-week Period in Glycemic Target Range at Inclusion and Day 90
Time in hypoglycaemia < 70 mg/dl at inclusion
4.7 percentage of time
Standard Deviation 4.6
Percentage of Time Spent Over a 4-week Period in Glycemic Target Range at Inclusion and Day 90
Time in hypoglycaemia < 70 mg/dl at D90
2.1 percentage of time
Standard Deviation 1.7
Percentage of Time Spent Over a 4-week Period in Glycemic Target Range at Inclusion and Day 90
Time in hyperglycaemia > 180 mg/dl at inclusion
37.8 percentage of time
Standard Deviation 14.9
Percentage of Time Spent Over a 4-week Period in Glycemic Target Range at Inclusion and Day 90
Time in hyperglycaemia > 180 mg/dl at D90
26.4 percentage of time
Standard Deviation 9.5

Adverse Events

Hybrid Closed-loop Automatic Insulin Delivery System

Serious events: 0 serious events
Other events: 12 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Hybrid Closed-loop Automatic Insulin Delivery System
n=35 participants at risk
A closed-loop automatic insulin delivery system includes a combination of an insulin pump, a continuous glucose monitoring system and an algorithm.
General disorders
Asthenia
5.7%
2/35 • Number of events 2 • From the time signed informed consent is obtained until the end of the study for the patient, up to 3 months
General disorders
Catheter site erythema
5.7%
2/35 • Number of events 2 • From the time signed informed consent is obtained until the end of the study for the patient, up to 3 months
General disorders
Catheter site inflammation
5.7%
2/35 • Number of events 2 • From the time signed informed consent is obtained until the end of the study for the patient, up to 3 months
Metabolism and nutrition disorders
Diabetic ketosis
8.6%
3/35 • Number of events 4 • From the time signed informed consent is obtained until the end of the study for the patient, up to 3 months
Metabolism and nutrition disorders
Hyperglycaemia
8.6%
3/35 • Number of events 3 • From the time signed informed consent is obtained until the end of the study for the patient, up to 3 months
Metabolism and nutrition disorders
Ketosis
5.7%
2/35 • Number of events 2 • From the time signed informed consent is obtained until the end of the study for the patient, up to 3 months

Additional Information

Marie-Danielle MILCENT / Clinical Project Manager

Air Liquide

Phone: +33 (0)1 84 76 42 39

Results disclosure agreements

  • Principal investigator is a sponsor employee The only disclosure restriction on the PI is that the Sponsor can review results communications prior to public release. According to Article R. 5121-13 of the French Public Health Code, the results of the Research may not be published or the subject of written or oral communications by the PI without prior written consent of the Sponsor.The disclosure restriction applies to the Parties during the entire duration of the agreement and as long as the confidential data are not in the public domain.
  • Publication restrictions are in place

Restriction type: OTHER