1939-P: Clinician Perspectives on Implementing Continuous Glucose Monitoring in the Hospital and Discharge Settings

Introduction and Objective: Continuous glucose monitoring (CGM) improves patient outcomes across healthcare settings, yet widespread implementation in hospital and discharge settings is limited. This study identified barriers and facilitators to CGM implementation in these settings from the perspective of front-line clinicians to inform effective implementation strategies. Methods: We conducted semi-structured interviews with 13 clinicians within two US hospital systems, including nurses (n=3), hospitalists (n=4), endocrinologists (n=3), and clinical pharmacists (n=3). We used directed content analysis guided by the Health Equity Implementation Framework to identify themes and organized findings across five domains: innovation, patient-clinician encounter, clinician and patient factors, organizational context, and societal influences. Results: Barriers were consistent across both institutions, including technical challenges (connectivity and hardware issues), knowledge deficits (insufficient clinician training), patient-level factors (low health literacy, language barriers, medical mistrust, privacy concerns), and organizational constraints (poor EHR integration, lack of standardized protocols, regulatory limitations). Clinicians serving under-resourced populations identified equity-related concerns in discharge settings, including out-of-pocket costs for continued use, limited access to CGM-compatible devices, and transportation barriers to pharmacy and follow-up visits. Facilitators included real-time glucose monitoring and team-based support (CGM champion, pharmacist, prior authorization specialist). Conclusion: Successful CGM implementation requires a multi-level approach linking identified barriers to targeted strategies, including technical infrastructure, workforce and patient education, and organizational systems. Equity-focused strategies are needed to ensure device access and affordability for under-resourced populations, especially during care transitions. Disclosure E. San Diego: None. A. Wallia: Research Support; Current; UnitedHealth Group. R. Beidas: Research Support; Current; Sanofi. A. Gonzalez: None. N.T. West: None. S. Subramanian: None. A. Philis-Tsimikas: Research Support; Current; Dexcom, Inc., Lilly, Novo Nordisk. Advisory Panel; Current; Novo Nordisk, Gan Current; Sanofi-Aventis U.S. Funding National Institutes of Health (R01 DK124427-04S1)National Institutes of Health (R01 DK124427)National Institutes of Health (UM1 TR004407) National Institutes of Health (K01 DK140528)