‘Smart’ questionnaire could refocus diabetes consultations
medwireNews: Completing a brief, adaptive questionnaire prior to each consultation with healthcare providers can focus discussions toward the immediate priorities and concerns of people with diabetes, shows a feasibility study.
Of note, a majority of people who completed the Spotlight algorithmic questionnaire (AQ) selected priorities relating to the psychologic burden of diabetes. This was the case regardless of whether they had type 1 or type 2 diabetes and as much, if not more, for men compared with women.
“We believe [this tool is] the missing link in diabetes management clinical care currently,” said Katharine Barnard-Kelly (Southern Health NHS Foundation Trust, UK), who presented the results at the virtual 2021 ATTD conference.
She added: “When people come to clinic, they find it very difficult sometimes to explain what their priority concerns are, and where they’re struggling to manage their diabetes in the context of their broader lived experience, so consultations can be quite frustrating for both patients and healthcare professionals.”
Barnard-Kelly explained that the tool takes 3–5 minutes to complete and generates two priorities for discussion, with results instantly and independently available to both the person with diabetes and their healthcare provider via a secure portal.
The “smart” tool has fewer than 40 questions, she said, and is adaptive, with the exact number and type of questions asked dependent on the user’s answers to initial questions.
“The goal is to give everybody the same opportunity for their voice to be heard in routine clinical care,” said Barnard-Kelly.
This feasibility study involved 49 participants across three centers, of which two were primary care and one was secondary care, two were in the UK and one in the USA.
The psychologic burden of diabetes was by far the most common priority area for these participants. It was selected by 27 of the 31 people with type 1 diabetes (aged between 19 and 67 years) who completed the Spotlight AQ and by all of the 18 people with type 2 diabetes (aged between 35 and 65 years).
This “really reflects the need for greater signposting of psychological resources when we don’t actually have them available within routine care,” said the presenter.
The other popular priority for people with type 1 diabetes was gaining more skills or knowledge about specific aspects of their condition, with 19 people selecting this priority, and eight people each identified priorities concerning diabetes treatment issues and improving their support.
People with type 2 diabetes gave equal priority to improving support and gaining skills or knowledge (seven people for each), but less to specific treatment issues (four people).
Barnard-Kelly noted that all participants highlighted current concerns, despite having the option of reporting no current concerns.
She said that the team is now undertaking a multicenter randomized controlled trial, with broad inclusion criteria, to determine the clinical utility and cost-effectiveness of the Spotlight AQ.
“It’s not who the patient is, it’s where the patient’s at that’s important,” she concluded.
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2021 Springer Healthcare Ltd, part of the Springer Nature Group