The increase in use of medical technology over the last few decades has improved the quality of healthcare for many individuals. Technologies such as electronic medical records, remote patient monitoring, and online messaging portals have increased patients’ access to information and improved patient satisfaction.1 However, there are many patients for whom these technologies are more of a burden than a blessing. One of the technologies that I frequently introduce to patients in my practice is continuous glucose monitors (CGMs).
Several studies have shown statistically significant improvements in measures of glucose control including reductions in hypoglycemia and glycosylated hemoglobin. 2,3 However, the use of these technologies can be challenging and intimidating to older adults. When discussing the benefits and potential use of CGMs with adults over 60, I have found that intimidation with new technologies is a common barrier to implementation. Another major barrier is cost. While cost varies among different plan options, many people with Medicare Part D are required to pay 20% of the cost of their CGMs, which may equate to approximately $50 per month. In my practice, many of my older adult patients have limited, fixed incomes and struggle to afford this additional cost, especially since their current glucometers are often covered through Medicare Part B with very little to no copays.
One of the ways I have tried to improve access to these technologies is to offset the cost of a CGM with lower costs from medications. Patients with lower incomes may qualify for patient assistance programs, even if they have Medicare, and this is one way to “find” funds so that patients can afford to use a CGM. What are some other resources or tricks that you have used to help improve access and comfortability with these technologies?
- Jimenez G, et al. The Role of Health Technologies in Multicomponent Primary Care Interventions: Systematic Review. J Med Internet Res 2021;23(1):e20195
- Pratley RE et al. Effect of continuous glucose monitoring on hypoglycemia in older adults with type 1 diabetes: A randomized clinical trial. JAMA 2020 Jun 16; 323:2397.
- Ruedy, et al. Continuous Glucose Monitoring in Older Adults With Type 1 and Type 2 Diabetes Using Multiple Daily Injections of Insulin: Results From the DIAMOND Trial. J Diabetes Sci Technol. 2017 Nov;11(6):1138-1146. doi: 10.1177/1932296817704445. Epub 2017 Apr 28.
- Diabetes.org. 2022. New Medicare Coverage Requirements Make CGMs More Accessible | ADA. [online] Available at: <https://www.diabetes.org/tools-support/devices-technology/cgm-medicare-coverage-requirement-change-accessibility> [Accessed 11 March 2022].