Operations and Decision Systems, Universite Laval Faculte des sciences de l'administration, Quebec, Quebec, Canada
Centre de recherche du CHU de Québec-Université Laval, Quebec, Quebec, Canada.
BMJ Open. 2021 Nov 25;11(11):e046757. doi: 10.1136/bmjopen-2020-046757.
Examine variations in parent's preferences for their child's type 1 diabetes (T1D) follow-up care and the determinants of the preferred intensity of care. Clinical guidelines recommend multidisciplinary management of T1D, with follow-up visits with an endocrinologist at least every 3 months in the paediatric population. However, there could be heterogeneity in parents' needs, and preferences in terms of care management may deviate from clinical guidelines.
Not applicable.
Parents who have a child living with T1D and who reside in Quebec, Canada.
In collaboration with a patient-partner (a parent of a child with T1D), we developed a survey to collect data from parents of children living with T1D. Our primary outcome of interest was the preferred time in months between two appointments. We ran a probit model to analyse longer time (over 3 months between appointments), compared with the standard of care (3 months or less).
Results suggest that about one-third (33%) of parents want to deviate from the guideline. Parents who want to increase the time between appointments are more experienced in the management of the disease and have higher costs than those who wish to follow the 3-month guideline. The number of years since the diagnosis is positively associated with a preference for a longer time between appointments, while the perceived useful of information provided during the consultation, and a parent having made a change in their professional life were negatively associated with a desire to space out appointments. The child's gender is not a significant factor in parents' preferences.
Adapting visit protocols could make the health system more efficient to respond to T1D patients and their parent's needs.
研究父母对其子女 1 型糖尿病(T1D)随访护理偏好的差异,以及影响护理偏好强度的决定因素。临床指南建议对 T1D 进行多学科管理,在儿科人群中,每 3 个月至少由内分泌医生进行一次随访。然而,父母的需求可能存在异质性,他们在护理管理方面的偏好可能与临床指南有所偏离。
不适用。
居住在加拿大魁北克省、有 T1D 子女的父母。
与一位患者伙伴(一名 T1D 患儿的家长)合作,我们开发了一份调查,以收集有 T1D 子女的父母的数据。我们主要关注的结果是两次预约之间的首选时间(以月为单位)。我们运行了一个概率模型来分析更长的时间(两次预约之间超过 3 个月)与标准护理(3 个月或更短)的差异。
结果表明,大约三分之一(33%)的父母希望偏离指南。希望增加预约间隔的父母在疾病管理方面经验更丰富,且成本高于希望遵循 3 个月指南的父母。自诊断以来的年限与更长的预约间隔偏好呈正相关,而在就诊期间感知到的有用信息以及父母在职业生活中的变化与延长预约间隔的愿望呈负相关。孩子的性别并不是父母偏好的重要因素。
调整就诊协议可以使卫生系统更有效地满足 T1D 患者及其父母的需求。