Abstract
BackgroundRecently, there has been growing interest in providing more tailored, patient-centered care for the treatment of type 2 diabetes mellitus (T2DM). Yet it remains unclear which patient characteristics should be determined to guide such an approach. Therefore, the opinions of healthcare providers (HCP) and people with T2DM about relevant patient characteristics for estimating healthcare needs of people with T2DM were assessed and compared.MethodsTwo separate online Delphi studies were conducted according to the RAND-UCLA Appropriateness Method: one with HCPs (n = 22) from Dutch primary and secondary care and one with people with T2DM treated in Dutch primary care (n = 46). The relevance of patient characteristics for estimating healthcare needs, defined as the number of yearly consultations, was assessed on a 5-point Likert scale. Characteristics with a median of 4 or 5 and an interquartile range ≤ 1.5 were considered relevant with consensus. Participants were also asked to select the top 5 of most relevant patient characteristics. To determine the overall top 5, the mean relative importance score of each characteristic was calculated.ResultsIn two Delphi rounds, 28 and 15 patient characteristics were rated by HCPs and people with T2DM, respectively. Both HCPs and people with T2DM found health-related characteristics relevant for estimating healthcare needs of people with T2DM. However, HCPs preferred to estimate healthcare needs using person- and context-related characteristics. They ranked self-efficacy as the most relevant estimator. In contrast, people with T2DM were more in favor of health-related characteristics and ranked HbA1c as the most relevant estimator.ConclusionsThe findings show that there is discrepancy in opinions on relevant patient characteristics for estimating healthcare needs between HCPs and people with T2DM. To achieve more tailored, patient-centered care, it is important that both groups agree on the topics to be discussed during patient consultations.
Highlights
There has been growing interest in providing more tailored, patient-centered care for the treatment of type 2 diabetes mellitus (T2DM)
The first Delphi study was conducted from September through October 2016 and included a purposive and representative sample of healthcare providers (HCP) recommended in the care protocols to be part of the multidisciplinary care team for the treatment of T2DM
Delphi rounds 1 and 2 healthcare providers The results of round 1 in the HCPs are shown in Table 2, 18 characteristics were rated as relevant
Summary
There has been growing interest in providing more tailored, patient-centered care for the treatment of type 2 diabetes mellitus (T2DM). In accordance with evidence-based care protocols for T2DM treatment, people with T2DM regularly visit healthcare providers (HCP) who should assist them in obtaining the knowledge and skills to self-manage their disease with confidence (e.g. day-to-day blood glucose monitoring, medication intake and lifestyle adjustment) [7, 8]. Adhering to these behaviors has been positively correlated with glycemic control [9, 10]. Several studies have pointed towards psychosocial characteristics, such as self-esteem, self-efficacy and quality of life to tailor care [16, 17], whereas others emphasize the relevance of biomedical characteristics, such as body mass index (BMI) and HbA1c [18, 19]
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