Quality of life, burden of treatment, safety, and avoidance of future events (QBSAfe) protocol: a pilot study testing an intervention to shift the paradigm of diabetes care

Pilot and Feasibility Studies

Weronika Pasciak¹  Derek Gravholt²  Kasey R. Boehmer²  Jennifer E. Clark²  Sandra A. Hartasanchez²  Omar M. El Kawkgi²  Victor Montori²  Brianna B. Sanchez²  Kasia J. Lipska³  Shanzay Haider³  Maggie Breslin⁴ 

[1] Frank H. Netter MD School of Medicine, Quinnipiac University, Hamden, CT, USA;Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA;Section of Endocrinology, Yale University School of Medicine, PO Box 208020, 06520, New Haven, CT, USA;The Patient Revolution, Rochester, MN, USA;

关键词: Diabetes;    Patient-centered;    Conversation aid;    Clinical toolkit;    Chronic disease management;   

DOI  :  10.1186/s40814-021-00935-8

来源: Springer

【 摘 要 】

BackgroundDiabetes care has been traditionally focused on targeting certain levels of glycemic control. This narrow emphasis may impose burdens on patients, including high treatment costs, illness-related work, or side effects from medications, while leaving other patient needs and goals under-addressed. The authors aim to shift the paradigm of care for people with diabetes, to focus on quality of life, burden of treatment, safety, and avoidance of future events: the QBSAfe domains.MethodsWe describe a single-arm pilot study to assess the feasibility and acceptability of using the QBSAfe agenda setting kit (ASK) during routine clinical visits. The set of 14 conversation aid cards was co-developed with patients, family caregivers, and clinicians. The ASK will be used in the context of a clinic visit, which will be recorded by members of the study team to identify patterns of clinician-patient conversations. Feasibility will be measured by the number of participants recruited, time to goal accrual, and completeness of data collection; acceptability will be assessed using post-visit surveys of patients and clinicians. A subgroup of patients will be invited to participate in post-visit qualitative semi-structured interviews for additional feedback. This study will be conducted across three medical centers in the Midwest and East Coast of the USA.DiscussionCurrent healthcare infrastructure and associated demands and pressures on clinicians make changes in care difficult. However, this intervention has the potential to shift conversations during clinical encounters so they can address and directly respond to patient needs, symptoms, and capacity. As part of the QBSAfe ASK, the authors are also actively collaborating with a variety of stakeholders to create tools to help clinicians respond more effectively to patient concerns as they are raised during the clinical encounters. Additional insights about the use of the QBSAfe approach in the virtual space will be gathered during the process of our study due to restrictions imposed upon face to face visit during the COVID-19 pandemic.Trial registrationClinicalTrials.gov, NCT04514523. Registered 17 August 2020—retrospectively registered.

【 授权许可】

CC BY