Diabetes Monitor Customer Journey

Part
01
of four
Part
01

Diabetes Monitor Customer Journey - Doctors

The exact journey of Canadian Health Care Professionals who are diagnosing diabetes and subsequently prescribing a blood glucose meter does not appear to be available in the public domain. Below, the research team has highlighted some helpful findings and provided an outline of the research strategies deployed in an attempt to obtain the requested information.


Helpful findings



Research strategy


To start the search, the research team has searched healthcare publications such as Healthline, the American Association of Clinical Endocrinologists and WebMD, searching for reports on the topic. The idea behind this search attempt was that patients want to know the decision-making process of doctors when it comes to glucose meters, which is why the patient advice publications might report on this topic. While information on the decision-making journey was available in these types of sources, the information focused on patients rather than doctors. Some scattered information regarding the process doctors go through when prescribing a blood glucose meter was available in these types of sources, however this was very brief and focused exclusively on the prescription process. No information was uncovered regarding where and how doctors are educated about these products, why they convert from non-consumer to consumer or what prevents them from converting.

Next, we have scanned research databases such as Semantic Scholar, Research Gate and the National Center for Biotechnology Information, searching for studies, academic articles and research papers that focus on this topic, hoping to find relevant insights specific to Canada. Our goal was to find data-backed studies which we could use to answer the query, or a least to locate relevant insights that are specific to Canada. Even though many studies focused on patients' confidence in doctors' decisions surrounding diabetes treatment, those that specifically described the doctors' decision-making process were not focused on Canada, instead, the studies were focused on another specific country such as Ireland. After exhaustive search through studies, no relevant insights specific to Canada were uncovered, which is why this strategy has also failed.

Following this, the research team has turned to locating direct statements from Canadian doctors and health care professionals themselves that concern the journey of diagnosing diabetes and prescribing a glucose meter, specifically surrounding where and how they learn about the products and what motivates them to buy it, as well as what might prevent them from buying or using the glucose meters. We've deployed this strategy because of an assumption that clinicians themselves likely know the physicians' journey surrounding glucose meter implementation and might disclose this information publicly. To find this information, we've consulted various Canadian clinician blogs including Cmaj Blogs and the Canadian Medical Association. What we hoped to find were interviews with physicians, or articles written by physicians that address the topic under investigation. After extensive search, the team uncovered no relevant interviews, blog articles or statements that specifically focused on Canada. The available information did not pertain to glucose meter products in particular and focused on the global level, with some information focusing on the US.


Part
02
of four
Part
02

Diabetes Monitor Customer Journey - Newly-Diagnosed Patients

Research conducted on a newly-diagnosed diabetes patient's journey to acquire blood glucose meters revealed that that patients (both new and old) who are considering switching to a different blood glucose meter or monitoring system rely on product studies and their fellow diabetes sufferers to evaluate which product to use. Motivating factors for choosing a product include the severity of the patient's condition and the product's accuracy and convenience. Barriers include the cost of devices and the pain associated with testing. After thorough research, we could not find data specific to newly diagnosed diabetes patients acquisition of a blood glucose meter.

Key findings

  •  According to our findings, diabetes patients turn to discussion forums to explore options for blood glucose meters, as they value the experience of other patients.
  • A patient at the TU Diabetes patient discussion forum references a study where she found information on products that prompted her to switch to Freestyle Lite after trying Verio and Dexcom products because of Feestyle Lite's accuracy.
  • According to a review by a Canadian mother and her son diagnosed with Type 1 diabetes, they switched to a continuous glucose monitor because they were getting up every three hours during the night to check his blood sugar levels, and the new monitor does it automatically, alerting them with an alarm if there is a problem.
  •  Accuracy appears to be a motivating factor for patients switching brands, according to some patient commentary, such as a slightly dated (July 2017) discussion at TU Diabetes.
  •  Ease of use and convenience are factors that may sway some diabetes patients in Canada to switch from one brand to another, such as seniors.
  • Some patients state that challenges in keeping them on the continuous glucose monitor because their insurance no longer covers the device, which costs roughly $4,000 per year is one of the barriers to acquiring a blood glucose meter
  • According to a 2018 CARP (Canadian Association for Retired Persons) member survey, which noted "unaffordability of test strips and the pain of testing as two of the major barriers to regular glucose monitoring."

RESEARCH STRATEGY

We began by searching Canadian diabetes advocacy organizations, such as Diabetes Canada, in search of newly diagnosed patient stories regarding blood glucose meter choices, but we only found data related to managing diabetes and cost barriers and nothing specific to the journey of patients who were newly-diagnosed with diabetes acquisition of a blood glucose meter.
We then looked for Canadian consumer reviews of blood glucose meters, hoping to find comments that would suggest why new consumers were switching from one brand to another, but the reviews offered only reflections of that particular product with no evidence that the consumer was switching from another brand.
Then, we search for polls or surveys conducted among Canadian diabetes patients to look for commentary or trends that might suggest why a consumer would switch from one brand to another. While such polls or surveys were quite limited, one reference to a CARP (Canadian Association for Retired Persons) survey highlights some relevant information though not specific to newly diagnosed diabetes patients.
Finally, we looked for Canadian patient community forums to look for discussions about product choices. We check Diabetes Canada to see if they had a patient discussion forum, but no forum was found. As Canada-specific forums were limited, we expanded to other forums to evaluate the discussions, which led to some value insights regarding patients switching products but not specifically to newly diagnosed patients.
Part
03
of four
Part
03

Diabetes Monitor Customer Journey - Existing Patients

Existing diabetes patients who are considering switching to a different blood glucose meter or monitoring system rely on product studies and their fellow diabetes sufferers to evaluate which product to use. Their motivations for choosing a product include the severity of the patient's condition, and the product's accuracy and convenience, while barriers include cost and the pain associated with testing.

WHERE AND HOW EXISTING PATIENTS LEARN ABOUT PRODUCTS

  • Patient discussion forums appear to be one place patients turn to explore options for blood glucose meters, as they value the experience of other patients.
  • A patient at the TU Diabetes patient discussion forum references a study where she got information on products that prompted her to switch to Freestyle Lite after trying Verio and Dexcom products because of its accuracy.
  • While not a Canadian forum, the Discussions section of the American Diabetes Association also suggests that patients rely on each other for information on glucose monitoring products to purchase.

MOTIVATIONS

  • The severity of the patient's diabetes may have an effect on which product they choose.
  • A Canadian mother and her son, who has Type 1 diabetes, switched to a continuous glucose monitor because they were getting up every three hours during the night to check his blood sugar levels, and the new monitor does it automatically, alerting them with an alarm if there is a problem.
  • Accuracy appears to be a motivating factor for patients switching brands, according to some patient commentary, such as a slightly dated (July 2017) discussion at TU Diabetes.
  • Ease of use and convenience are factors that may sway some diabetes patients in Canada to switch from one brand to another, such as seniors.
  • Charlene Lavergne, a Canadian senior who has lived with diabetes for 40 years, switched to the FreeStyle Libre because of its convenience and lack of pain.

BARRIERS

  • The aforementioned Canadian mother and son are facing challenges in keeping him on the continuous glucose monitor because her insurance no longer covers the device, which costs roughly $4,000 per year.
  • Pain may be another factor that influences a patient's decision to use one glucose monitoring product over another, according to a 2018 CARP (Canadian Association for Retired Persons) member survey, which noted "unaffordability of test strips and the pain of testing as two of the major barriers to regular glucose monitoring."

RESEARCH STRATEGY

We began by searching Canadian diabetes advocacy organizations, such as Diabetes Canada, in search of patient stories regarding blood glucose meter choices, but we only found data related to managing diabetes and cost barriers.

We then looked for Canadian consumer reviews of blood glucose meters, hoping to find comments that would suggest why consumers were switching from one brand to another, but the reviews offered only reflections of that particular product with no evidence that the consumer was switching from another brand.

Then, we search for polls or surveys conducted among Canadian diabetes patients to look for commentary or trends that might suggest why a consumer would switch from one brand to another. While such polls or surveys were quite limited, one reference to a CARP (Canadian Association for Retired Persons) survey highlights some relevant information.

Finally, we looked for Canadian patient community forums to look for discussions about product choices. We check Diabetes Canada to see if they had a patient discussion forum, but no forum was found. As Canada-specific forums were limited, we expanded to other forums to evaluate the discussions, which led to some value insights regarding patients switching products.
Part
04
of four
Part
04

Diabetes Monitor Customer Journey - Features

Features that are important to Canadian patients and/or recommended by doctors in blood glucose meters are the flash glucose monitoring features. Other important features are alert features, pain and discomfort minimization features, voice functions and remote viewing of glucose data.

FLASH GLUCOSE MONITORING FEATURE

  • Flash glucose monitoring feature entails tracking historical glucose readings. Flash glucose monitoring has an exceptional capability to measure glucose after every defined moment in interstitial fluid through a tiny filament that is put under the skin and positioned by a small adhesive pad. Glucose levels are displayed on demand when the sensor is waved over, or "flashed", with a hand-held scanner.
  • Glucose level data, in this monitoring technology, is measured, captured, and stored automatically and continuously. This feature is very important for both patients and their doctors, so that they can see patterns over time and make adjustments to lifestyle, diet or treatment, when needed.
  • The FreeStyle Libre system was the first-ever flash glucose monitoring system that was created by Abbott and authorized for sale by Health Canada in 2017. This system covered by a majority of private health insurance companies.
  • Users of the flash glucose monitoring system can also share their comprehensive readings digitally with their doctors and use the information to better manage their lifestyles.

VOICE FUNCTIONS — TALKING FEATURE

  • The extra large screen and talking functions of the blood glucose meter make it easy for users to know their readings.
  • Patients have reviewed and recommended that the voice functions, especially the talking feature, is useful and important for older patients with eyesight problems. This feature will help them know their readings easily. Also, this talking meter is more reliable.

ALERT FEATURE- CONTINUOUS GLUCOSE MONITORING (CGM) DEVICES

  • CGM measures glucose levels in the fluid surrounding the cells (interstitial fluid).
  • These glucose readings are sent from the “transmitter” to a “receiver” which displays the current glucose level, as well as the glucose trends so that you can take action as needed.
  • The Alert feature of CGMs will notify the patients when their glucose is low and when their glucose is above the target range (which allows the patient to take corrective action earlier). In addition, Rate of Change Alerts notify the patient if their blood sugar is dropping or rising quickly. Alerts offer safety and peace of mind for persons living with diabetes and their families.

PAIN AND DISCOMFORT MINIMIZATION FEATURE

  • Flash and CGM Glucose monitoring system measure glucose levels of the intestinal fluid with the help of sensors that replace of the pokes demanded by the more conventional fingerstick blood glucose meter.
  • Based on research, a fear of pain and needles, and the inconvenience of the self-monitoring process are obstacles in good blood glucose control. The Flash and CGM glucose monitoring systems addresses these obstacles.
  • For patients who prioritize reduction in finger pricks, they would focus on a system such as Dexcom that is approved to replace fingerstick glucose checks for treating lows and correcting highs.
  • This is very helpful for the patients as the demands of frequent BG checks can wear them out.
  • This feature is important for both patients and doctor as once the doctor ascertains that this is a pain point for the patient in monitoring their blood glucose, they would recommend this option for the patients, resulting in better care and treatment.
  • Danny, a Canadian senior who has lived with diabetes for 6 years, switched to the FreeStyle Libre as that provided an alternate option to measure glucose levels without the pain. He did this on the recommendation of his endocrinologist.

REMOTE VIEWING OF GLUCOSE DATA

  • The feature of remote viewing enables the patient to remotely share their glucose readings in real-time with other people with a spouse or family member who is outside of the communication range of the system, or even in a different location.
  • This is a compulsory feature for parents of children with Type 1 as the kids are not able to reliably recognize their low sugars and take action on them. Parents can remotely view their daughter’s glucose data while she’s in the middle of a hockey game, or their son’s data while he’s over a friend’s house.
  • This feature is important for both the patient and the doctor. With this feature, the doctor can remotely view the patient's data in real-time and timely intervene for any changes. This feature will help kids who are diabetic to readily share their data with parents/family members.

RESEARCH STRATEGY

We began by our research by looking for information in the Canadian diabetes advocacy organizations on patient stories regarding blood glucose meter choices, but we only found data related to managing diabetes and cost barriers. We then consulted the surveys conducted among Canadian diabetes patients to look for commentary or trends that might suggest on what features of blood glucose meters are popular among the Canadian Patients While such polls or surveys were quite limited, one reference to a CARP (Canadian Association for Retired Persons) survey highlighted some relevant information. Finally, we looked for Canada Product forums such as Foracarecanada, press articles, and blogs on blood glucose monitors used in Canada for valuable insights regarding patients /doctors reviews on product usage. Based on the features of these products, we were able to determine the reasons why these features were important and whether these features addressed the pain points of the doctors or patients. From these resources, important features in blood glucose meters recommended to Canadian patients include flash glucose monitoring features, alert features, pain and discomfort minimization features, voice functions and remote viewing of glucose data.
Sources
Sources

From Part 03
Quotes
  • "For Nadine Pedersen and her teenage son Hudson, who has Type 1 diabetes, getting a glucose-monitoring device was life-changing — and potentially life-saving for him."
  • "Now, with the tiny sensor under his skin, his glucose levels are measured automatically hundreds of times a day. An alarm goes off it anything happens in the middle of the night. "
Quotes
  • "The experience of @AE13 matches exactly my experience with the Verio. The two start-up readings for my Dexcom were sometimes close together but often farther apart than I was comfortable with. Based on this study shared on Diabetes Daily 6, I switched to Freestyle Lite and I was very impressed with the repeatability of readings. IMO more consistent meter results lead to better CGM results."
Quotes
  • "Recent tests do give the Contour Next meter high marks. Most brand name meters are gong to be consistent and competitive as accuracy is concerned, so you might look at what strips cost to you. This can range from 20 cents to more than a couple of dollars per strip."
  • "For background, I personally have used Contour Next for the past 6 years since I began pumping, as they communicate with my Medtronic pump. However, prior to that I was using Freestlye meters (first Freestyle, then Freestlye Lite) and had no problem with them. I've used a few other meters during that time as well, such as if I bollowed someone else's if I forgot mine, or when an Endo gave me a sample to hold me over while insurance issues muddied the works. None of the others have particularly impressed me, and there were one or two I definitely disliked, but I can't recall exactly which."
Quotes
  • "A 2018 CARP member survey5 revealed that the majority of respondents (65%) who are living with diabetes or caring for someone with diabetes check their glucose levels as little as one to three times a day. The survey showed the unaffordability of test strips and the pain of testing as two of the major barriers to regular glucose monitoring."
  • "“I’ve been pricking my fingers for six years,” Danny explains—so when FreeStyle Libre system became an option, Danny’s endocrinologist told him to “go for it”. The FreeStyle Libre system offers him a full eight hours’ worth of data on his glucose levels—a constant aid for managing his diabetes."
Quotes
  • "I don't know of any approved meters so bad I would not use them. The best meter is the one you can afford to use as often as you need to. Use it often enough and you'll know its idiosyncracies and whether you need to adjust results slightly."
  • "I have 3 meters that read the same as the lab tests: Accu-chek Aviva, Freestyle Freedom Lite, and ReliOn All in One. These are also close to the readings I get from my Freestyle Libre CGM, which is sometimes about the same, sometimes a few points higher or lower, and occasionally 5-10 points higher or lower -- varying by about the same amounts as any various meter and strips variations. I think that's pretty good, considering the Libre is measuring interstitial fluid."
Quotes
  • "“The FreeStyle Libre system has changed my life and given me back time to enjoy the things I like to do,” says Lavergne, “It’s easy to swipe my sensor to get a quick reading. I am able to test more this way without having to worry about the pain of finger pricks."
  • "For seniors like Charlene who has lived with diabetes for more than 40 years, being able to check glucose levels discreetly and conveniently at any time is important."