A focus on integrating patient-reported outcomes in clinical practice

One of our highlights from the 77th Scientific Sessions of the ADA. 

by Prof Jane Speight


On Saturday 10 June, Dr Michael Harris (Oregon Health & Science University) received the prestigious Richard Rubin Award 2017, recognising outstanding and/or innovative contributions in the study and understanding of the behavioural aspects of diabetes. His lecture entitled “Your exclusion, my inclusion – treating the most challenging in diabetes” provided food for thought about how we design our interventions and their limited usefulness for real-world implementation. He raised the point that often the most vulnerable are excluded from our research, while they have the most to gain from it. The homogenous samples researchers report on do not enable generalisation of our results and it is very unlikely they will benefit a broader population. Dr Harris received his award in recognition of his substantial work focused on adolescents with type 1 diabetes, a group who are typically considered ‘challenging’ by many clinicians and researchers but who have much to gain from well-targeted interventions.

Further in this session, several authors of the ADA position statement on psychosocial care presented on various aspect of the recommendations. Dr Mark Peyrot (Loyola University) talked about why and how the position statement and recommendations were developed. The next speakers gave some more details on integrated person-based team care (Dr Deborah Young-Hyman), on the screening measures (Dr Mary de Groot) and pathways of implementation (Dr Felicia Hill-Briggs). This position statement was needed. There is no question that psychological care should be an integral part of person-centred and person-tailored approach.

The Patient-Reported Outcomes session, on Sunday 11 June, nicely complemented the Position Statement session, providing examples of implementation. Dr Sarah Corathers (Cincinatti Children’s Hospital Medical Center) shared with the audience how they have successfully integrated a screening program into their paediatric clinic. As part of routine clinical practice, the children complete psychological questionnaires assessing quality of life and depressive symptoms. However, she also mentioned the challenges in keeping the clinical staff motivated. She emphasised that all parties need to be aware of benefits for everyone involved. Dr Paul Ciechanowski (University of Washington) gave a detailed overview of questionnaires available to assess the most common psychological constructs. He also highlighted how using these measures help us to connect and engage with our clients. Dr Julie Wagner (University of Connecticut Health Center) drew our attention to consider alternative approaches to assess psychological status for different cultures. Validated standardized questionnaires are not suitable for all cultures. Interviews, pictographics or audio format may be more appropriate. Lastly, Dr Jeff Gonzalez played ‘devil’s advocate’, challenging the recommendation of whether it is advisable to screen routinely for depression.

If you have an interest in how to incorporate psychological care into your practice, take a look at our free Handbook, which provides a useful model and tools to address the psychological well-being of adults living with diabetes.

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