VOIES-D-ql - Qualitative Study on Experiences of Diabetes Care Delivery and Planning

Civil Hospices of Lyon

Status: Completed

Conditions: Diabete Type 1; Diabete Type 2

Treatments: Other: Description of patients' experiences of diabetes care delivery and planning; Other: Description of health care professionals needs and experiences in diabetes care delivery and planning

Study type: Observational

Funder types: Other

Identifiers

NCT04217902

69HCL19_0897

Details and patient eligibility

About

Population aging and the increase in incidence and prevalence of potentially disabling chronic conditions make health care more and more complex and costly. In this context, timelines are longer and adherence to care provision and health status are more variable - both within and between patients - and care is provided by different health care professionals, as well as services outside the health system, which may work at various levels of service integration. For diabetes, this is especially the case: patients at high risk for multimorbidity interact with multiple health care professionals, such as primary care physicians, diabetes specialists, nurses, nutritionists and therapeutic educators, with different perspectives to treatment. The patient is frequently the only link between the different health care professionals, and very often the main source of information regarding performed procedures, diagnoses and treatment decisions.

A current challenge facing all health care stakeholders, including policy makers, practitioners, businesses, and patients, is to coordinate the available services and integrate care ensuring safety, effectiveness, and comprehensiveness in relation to the needs of individual users across the lifespan. Routine collected data can provide key information to completely assess a patient's health status and thus help evaluating and deciding adapted steps in treatment to stabilize or improve clinical outcomes.

In France, the Dossier Medical Partagé (Shared Medical Record) represents an effort to centralize and improve accessibility, to patients and professionals alike, of medical information. This system is yet little adopted and there is the need for added value initiatives to exploit the tool's potential. In other countries, like the UK, the governmental unit NHSX develops public policies and good practices for the digital transformation of the NHS. In the United States, working groups like the Health Information Technology Working Group, in the National Institute of Diabetes and Digestive and Kidney Diseases, develop electronic care plans using Electronic Health Record data for chronic kidney disease patients. These initiatives, among others, show the necessity of simple, visual communication in order to build a comprehensive care delivery pathway to inform decision and further care planning, according to health goals set by shared decision-making.

This study aims to describe individual experiences of chronic care delivery of people living with diabetes and also from healthcare professionals working in diabetes care from 3 different domains: clinical (relevant clinical criteria necessary for the decision-making process, goal setting and planning), technological (tools used in routine practice and in patients' daily lives), and behavioural (behaviours and interactions that build the patient's pathway and strategies implemented by patients and professionals to help the decision-making process).

Locations of the study : Primary and secondary healthcare facilities and patient associations in Lyon and Grenoble areas

Enrollment: 33 patients

Sex: All

Ages: 18+ months old

Volunteers: No Healthy Volunteers

Inclusion criteria

Patient

• At least 18 years old
• Diagnosed with type 1 or type 2 diabetes according to HAS criteria and confirmed by and endocrinologist since at least one year
• Having had at least one consultation with a health care professional in the last 12 months
• Able to communicate in French
• Able to participate in an interview and not opposing to participate in the study

Professional

• Having at least one year of professional experience in diabetes care
• General practitioner, endocrinologist, diabetologist, intern, nurse, nutritionist or professional specialized in therapeutic education

Exclusion criteria

Patient

• Inability to communicate in French
• Institutionalized person

Professional

• Professional not having had at least one consultation with a person living with diabetes in the last 12 months

Trial design

33 participants in 2 patient groups

People living with diabetes in Grenoble and Lyon areas

Description:

Eligible patients with type 1 or type 2 diabetes 1) during or after hospitalization for decompensation, ketoacidosis, or other emergency or elective interventions such as insulin pump installation, 2) followed in routine care in specialized diabetes services, 3) participating in patient associations.

Treatment:

Other: Description of patients' experiences of diabetes care delivery and planning

Health care professionals working in diabetes care in Grenoble

Description:

Health care professionals working with diabetes care in specialized services or ambulatory care.

Treatment:

Other: Description of health care professionals needs and experiences in diabetes care delivery and planning