2809-LB: Understanding CGM Use in Insulin-Requiring Diabetes within Federally Qualified Health Centers (FQHCs): Focus Groups with Primary Care Providers (PCPs)

Introduction and Objective: This study aimed to learn more about the use of continuous glucose monitors (CGM) in Federally Qualified Health Centers (FQHCs) including the facilitators and barriers of use. Focus groups were conducted with primary care providers (PCPs) working in FQHCs. Methods: PCPs who treat patients with Type 1 Diabetes (T1D) or insulin-requiring Type 2 Diabetes (T2D) were recruited from FQHCs nationally. The Consolidated Framework for Implementation Research (CFIR) was utilized to develop focus group domains and questions. Transcription and thematic analysis were conducted by Datagain Analytics using independent coders. Inter-rater reliability was evaluated using Cohen’s Kappa. Results: A total of 12 focus groups were conducted with 60 PCPs from 14 health centers across 7 states, including Puerto Rico. One session was conducted in Spanish, and 11 in English. Participants were predominantly female (77.1%) with a mean age of 44.4 (SD=13.8), 26.7% Hispanic/Latino, 42.1% non-white, and 34.4% were multilingual. A majority of participants were nurse practitioners (37.7%) or physicians (36.1%) and 75% had prescribed a CGM prior to the focus group. The most cited barriers were as follows: payer group policies, lack of knowledge about CGMs (PCPs and people with diabetes), and inability to access CGM data. Facilitators most cited included: diabetes educators, external partnerships that provide more CGM education and supplies, and prior authorization support for CGMs. Conclusion: Focus groups included a racially and ethnically diverse group of PCPs who treat medically underserved people with T1D and insulin-requiring T2D within FQHC settings. This study provides important new insight into larger quantitative studies documenting disparities in CGM use within FQHCs. Multi-level, tailored interventions are necessary at the local, state, and national levels to address the complex needs of FQHC PCPs. Disclosure B. Churba: None. S. Westen: None. W. Esmond: None. K.G. Malden: None. M.J. Haller: Advisory Panel; Current; MannKind Corporation, Sanofi, SAB Biotherapeutics, Inc. N. Marlow: None. J.W. Major: None. C. Walker: None. T. Long: None. S.T. Martinez: None. D.L. Kornetti: None. A.F. Walker: None. Funding The Leona M. and Harry B. Helmsley Charitable Trust (AWD15226)