Although many people with type 1 diabetes experience psychosocial challenges, psychosocial aspects of diabetes are not routinely addressed in diabetes consultations. This study explores to what extent the use of patient reported outcomes (PRO) on psychosocial issues in type 1 diabetes routine consultations can 1) improve dialogue about psychosocial health between diabetologists and patients and 2) improve diabetes empowerment, well-being and glycaemic control in people with type 1 diabetes.
The study consists of three consecutive phases. Phase 1 and 2 consist of adapting and feasibility testing an intervention that uses PROs. Intervention methods will be tested in diabetes consultations with iterative evaluations and adjustments of the intervention methods (including PROs). Phase 3 will consist of a randomised study to measure the effect of the intervention.
Different PROs will be explored, tested and adjusted in collaboration with people with type 1 diabetes and diabetologists. The methodological approach in this study is a combination of qualitative and quantitative methods with observations of consultations, interviews/workshops with people with diabetes as well as diabetologists and use of questionnaires.
The study is expected to provide insights on how to incorporate systematic monitoring of and dialogue about psychosocial problems in diabetes in an effective and not time consuming manner.
It is well known that many people with type 1 diabetes experience psychosocial challenges and that there is a significant association between diabetes distress and difficulties in diabetes self-management and higher HbA1c. However, little is known about how to address psychosocial problems effectively, e.g. in routine consultations, and the literature indicates that psychosocial problems are not routinely addressed in diabetes consultations. Reasons for this include lack of training among diabetologists, perceived lack of time and structural limitations. Therefore there is a need for a (new) approach to identify and address psychosocial health in clinical practice.
The overall aim of this study is to explore to what extent the use of PRO on psychosocial issues in type 1 diabetes routine consultations can:
- Improve dialogue about psychosocial health between diabetologists and patients
- Improve diabetes empowerment, well-being and glycaemic control in people with type 1 diabetes
The study is conducted as a collaboration between SDCC Diabetes Management Research (Lene Eide Joensen, Mette Nexø Andersen and Ingrid Willaing), SDCC Complication Research (Frederik Persson and Kirsten Nørgaard), Rigshospitalet (Thomas Almdal) and Nordsjællands Hospital (Frederik Persson).
Liv Dørflinger (SDCC) and Timothy Skinner (Head of Psychological and Clinical Sciences at Charles Darwin University – after January 1st 2018 professor at Institute of Psychology, University of Copenhagen) is also involved in the study.