P-212: Support around diabetic ketoacidosis prevention and management for people with type 1 diabetes - a needs analysis
S James, S Watts, A Hatt, C Gittens, T Frakking, O James, M Broadbent, K Furlong, L Perry, J Lowe, S ClarkAbstract
Introduction
Australia has one of the highest rates of type 1 diabetes (T1D) worldwide. A previous study described patterns of presentation for diabetic ketoacidosis (DKA) in patients with T1D to Caboolture Hospital Emergency Department (ED) in Queensland, between 2015-2019. From an estimated local population of 317 people with T1D, over half (n=165, 52.1%) had an index ED presentation for DKA, over half of which (n=92, 55.8%) occurred outside usual business hours (9am-5pm).
Objectives
Our study sought to explore perceived experiences and views of the support available to people with T1D for DKA prevention and management in Caboolture, and perceptions around service improvements.
Methods
This was a concurrent mixed methods study: 1.) a survey of healthcare professionals (HCPs); 2.) semi-structured HCP interviews; and 3.) a survey of people with T1D (or carers). Advertisement involved electronic newsletters, posters and direct contact. For surveys, variable relationships were examined using Fishers Exact, Chi-square or t-tests. Data from interviews were analysed using Gibbs thematic framework.
Results
Study 1: 90 participants; nurses (64.4%) and physicians (23.3%) [overall mean±SD age=38.9±11.0 years]. Study 2: 13 interviews (nurses [69.2%], physicians [23.1%], and a pharmacist [7.7%]). Study 3: 10 participants; 70% people with T1D and 30% carers [patient age=38.5±14.8 years]. Collectively, findings indicate that both HCPs and people with T1D (or carers) overwhelmingly perceived the need for further support for people with T1D, which could be in the form of a designated video-conferencing portal or telephone support via a designated funded hotline.
Conclusions
Study findings can help to inform development of evidence-based solutions that can be tested in later projects, with the aim of reducing DKA episodes (and subsequent ED presentations and hospital admissions).