Skovlund Soren E, Troelsen Lise Havbæk, Noergaard Lise Mellergaard, Pietraszek Anna, Jakobsen Poul Erik, Ejskjaer Niels
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark.
JMIR Form Res. 2021 Nov 3;5(11):e28329. doi: 10.2196/28329.
Improvements in the digital capabilities of health systems provide new opportunities for the integration of patient-reported outcome (PRO) solutions in routine care, which can facilitate the delivery of person-centered diabetes care. We undertook this study as part of our development of a new digital PRO diabetes questionnaire and clinical dialog support tool for use by people with diabetes and their health care professionals (HCPs) to improve person-centered diabetes care quality and outcomes.
This study evaluates the feasibility, acceptability, and perceived benefits and impacts of using a digital PRO diabetes tool, DiaProfil, in routine outpatient diabetes care.
Overall, 12 people with diabetes scheduled for routine medical diabetes visits at the outpatient clinic were recruited. Purposive sampling was used to optimize heterogeneity regarding age, gender, duration, type of diabetes, treatment modality, and disease severity. Participants filled out a PRO diabetes questionnaire 2 to 5 days before their visit. During the visit, HCPs used a digital PRO tool to review PRO data with the person with diabetes for collaborative care planning. Participants completed evaluation forms before and after the visit and were interviewed for 30 to 45 minutes after the visit. HCPs completed the evaluation questionnaires after each visit. All visits were audio-recorded and transcribed for analysis. Data were analyzed using quantitative, qualitative, and mixed methods analyses.
People with diabetes found the PRO diabetes questionnaire to be relevant, acceptable, and feasible to complete from home. People with diabetes and HCPs found the digital PRO tool to be feasible and acceptable for use during the diabetes visit and would like to continue using it. HCPs were able to use the tool in a person-centered manner, as intended. For several people with diabetes, completion of the questionnaire facilitated positive reflection and better preparation for the visit. The use of the PRO tool primarily improved the quality of the dialog by improving the identification and focus on the issues most important to the person with diabetes. People with diabetes did not report any negative aspects of the PRO tool, whereas HCPs highlighted that it was demanding when the person with diabetes had many PRO issues that required attention within the predefined time allocated for a visit.
The Danish PRO diabetes questionnaire and the digital tool, DiaProfil, are feasible and acceptable solutions for routine diabetes visits, and this tool may generate important benefits related to advancement of person-centered care. Further research is now required to corroborate and expand these formative insights on a larger scale and in diverse health care settings. The results of this study are therefore being used to define research hypotheses and finalize real-world PRO evaluation tools for a forthcoming large-scale multisector implementation study in Denmark.
卫生系统数字能力的提升为将患者报告结局（PRO）解决方案整合到常规护理中提供了新机遇，这有助于提供以患者为中心的糖尿病护理。我们开展这项研究，作为开发一种新的数字PRO糖尿病问卷和临床对话支持工具的一部分，供糖尿病患者及其医护人员（HCP）使用，以提高以患者为中心的糖尿病护理质量和结局。
本研究评估在常规门诊糖尿病护理中使用数字PRO糖尿病工具DiaProfil的可行性、可接受性以及感知到的益处和影响。
总共招募了12名计划在门诊进行常规糖尿病医疗就诊的糖尿病患者。采用目的抽样法，以优化在年龄、性别、病程、糖尿病类型、治疗方式和疾病严重程度方面的异质性。参与者在就诊前2至5天填写一份PRO糖尿病问卷。就诊期间，医护人员使用数字PRO工具与糖尿病患者一起查看PRO数据，以进行协作护理规划。参与者在就诊前后完成评估表，并在就诊后接受30至45分钟的访谈。医护人员在每次就诊后完成评估问卷。所有就诊均进行录音并转录以供分析。使用定量、定性和混合方法分析数据。
糖尿病患者认为PRO糖尿病问卷相关、可接受且可以在家中完成。糖尿病患者和医护人员发现数字PRO工具在糖尿病就诊期间使用是可行且可接受的，并希望继续使用。医护人员能够按预期以患者为中心的方式使用该工具。对一些糖尿病患者来说，完成问卷有助于进行积极反思并为就诊做好更好的准备。PRO工具的使用主要通过改善对糖尿病患者最重要问题的识别和关注，提高了对话质量。糖尿病患者未报告PRO工具的任何负面方面，而医护人员强调，当糖尿病患者有许多PRO问题需要在为就诊分配的预定义时间内关注时，该工具要求较高。
丹麦的PRO糖尿病问卷和数字工具DiaProfil是常规糖尿病就诊的可行且可接受的解决方案，该工具可能会为以患者为中心的护理进步带来重要益处。现在需要进一步研究，以在更大规模和不同的医疗环境中证实并扩展这些形成性见解。因此，本研究的结果正用于确定研究假设，并为丹麦即将开展的大规模多部门实施研究确定实际的PRO评估工具。
