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Barriers to Uptake of Open-Source Automated Insulin Delivery Systems: Analysis of Socioeconomic Factors and Perceived Challenges of Adults with Type 1 Diabetes from the OPEN Survey

  • Shane O'Donnell
    Correspondence
    Corresponding author at: Research Scientist, OPEN Project Coordinator, School of Sociology, University College Dublin, Belfield, Dublin 4, Ireland.
    Affiliations
    University College Dublin, School of Sociology, Belfield, Ireland

    University of Copenhagen, Department of Psychology, Copenhagen, Denmark
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  • Author Footnotes
    1 Institute of Medical Informatics, Charité – Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
    Drew Cooper
    Footnotes
    1 Institute of Medical Informatics, Charité – Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
    Affiliations
    Charité - Universitätsmedizin Berlin, Institute of Medical Informatics, Berlin, Germany

    Charité - Universitätsmedizin Berlin, Department of Paediatric Endocrinology and Diabetes, Berlin, Germany

    Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, Germany
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  • Author Footnotes
    2 Michael Smurfit Graduate Business School, University College Dublin, Carysfort Avenue, Blackrock, Dublin, Ireland
    Yanbing Chen
    Footnotes
    2 Michael Smurfit Graduate Business School, University College Dublin, Carysfort Avenue, Blackrock, Dublin, Ireland
    Affiliations
    University College Dublin, Michael Smurfit Graduate Business School, Dublin, Ireland
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  • Author Footnotes
    3 #dedoc° Diabetes Online Community, Stargarder Str. 19, 10437 Berlin, Germany
    Hanne Ballhausen
    Footnotes
    3 #dedoc° Diabetes Online Community, Stargarder Str. 19, 10437 Berlin, Germany
    Affiliations
    Charité - Universitätsmedizin Berlin, Department of Paediatric Endocrinology and Diabetes, Berlin, Germany

    Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, Germany

    #dedoc° Diabetes Online Community, Dedoc Labs GmbH, Berlin, Germany
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  • Author Footnotes
    4 Seattle, WA, USA
    Dana M. Lewis
    Footnotes
    4 Seattle, WA, USA
    Affiliations
    OpenAPS, Seattle, WA, United States
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  • Author Footnotes
    5 School of Sociology, Belfield, Dublin 4, Ireland, University College Dublin
    Timothée Froment
    Footnotes
    5 School of Sociology, Belfield, Dublin 4, Ireland, University College Dublin
    Affiliations
    University College Dublin, School of Sociology, Belfield, Ireland
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  • Author Footnotes
    6 Diabetes Ireland, 19 Northwood House, Santry, Dublin 9, Ireland
    Katarzyna Anna Gajewska
    Footnotes
    6 Diabetes Ireland, 19 Northwood House, Santry, Dublin 9, Ireland
    Affiliations
    Diabetes Ireland, Dublin, Ireland
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  • Author Footnotes
    7 AndroidAPS, Halimton, New Zealand
    Adrian Tappe
    Footnotes
    7 AndroidAPS, Halimton, New Zealand
    Affiliations
    AndroidAPS, Hamilton, New Zealand
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  • Author Footnotes
    8 Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353 Copenhagen K, Denmark
    Timothy Skinner
    Footnotes
    8 Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353 Copenhagen K, Denmark
    Affiliations
    Australian Centre for Behavioural Research in Diabetes, Melbourne, Australia

    Department of Psychology, University of Copenhagen, Copenhagen Denmark

    La Trobe University, Bendigo, Australia
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  • Author Footnotes
    9 Department of Health Promotion Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark
    Bryan Cleal
    Footnotes
    9 Department of Health Promotion Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark
    Affiliations
    Steno Diabetes Center Copenhagen, Herlev, Denmark
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  • Author Footnotes
    10 Co-Lead Digital Transformation, Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
    Katarina Braune
    Footnotes
    10 Co-Lead Digital Transformation, Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
    Affiliations
    Charité - Universitätsmedizin Berlin, Institute of Medical Informatics, Berlin, Germany

    Charité - Universitätsmedizin Berlin, Department of Paediatric Endocrinology and Diabetes, Berlin, Germany

    Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, Germany
    Search for articles by this author
  • Author Footnotes
    1 Institute of Medical Informatics, Charité – Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
    2 Michael Smurfit Graduate Business School, University College Dublin, Carysfort Avenue, Blackrock, Dublin, Ireland
    3 #dedoc° Diabetes Online Community, Stargarder Str. 19, 10437 Berlin, Germany
    4 Seattle, WA, USA
    5 School of Sociology, Belfield, Dublin 4, Ireland, University College Dublin
    6 Diabetes Ireland, 19 Northwood House, Santry, Dublin 9, Ireland
    7 AndroidAPS, Halimton, New Zealand
    8 Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353 Copenhagen K, Denmark
    9 Department of Health Promotion Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark
    10 Co-Lead Digital Transformation, Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
Published:December 26, 2022DOI:https://doi.org/10.1016/j.diabres.2022.110235

      Highlights

      • OS AID has been shown to improve clinical outcomes and quality of life.
      • This is the first study to identify the most common barriers to uptake of OS AID among those currently not using such a system.

      Abstract

      Aims

      Social and technical trends are empowering people with diabetes to co-create or self-develop medical devices and treatments to address their unmet healthcare needs, for example, open-source automated insulin delivery (AID) systems. This study aims to investigate the perceived barriers towards adoption and maintaining of open-source AID systems.

      Methods

      This is a multinational study based on a cross-sectional, retrospective web-based survey of non-users of open-source AID. Participants (n=129) with type 1 diabetes from 31 countries were recruited online to elicit their perceived barriers towards the building and maintaining of an open-source AID system.

      Results

      Sourcing the necessary components, lack of confidence in one's own technology knowledge and skills, perceived time and energy required to build a system and fear of losing healthcare provider support appear to be major barriers towards the uptake of open-source AID.

      Conclusions

      This study identified a range of structural and individual-level barriers to uptake of open-source AID. Some of these individual-level barriers may be overcome over time through the peer-support of the DIY online community as well as greater acceptance of open-source innovation among healthcare professionals. The findings have important implications for understanding the possible wider diffusion of open-source diabetes technology solutions in the future.

      Keywords

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