Addressing diabetes distress among adults with type 2 diabetes in general practice

Our review examines use of Person Reported Outcome Measure in type 2 diabetes care

By Dr Rita McMorrow

People with type 2 diabetes are more likely to experience mental health problems than people without diabetes. Most people with type 2 diabetes see a general practitioner (GP) for their diabetes care. So, GPs need to be able to detect and address emotional concerns.

Diabetes guidelines advise that clinical care should include assessment of depression and diabetes distress. This can be done with a Person-Reported Outcome Measure (PROM). But our survey showed that it seldom occurs in general practice.

So, our aim was to examine how PROMs can be used to assess depression and diabetes distress in the routine care of people with type 2 diabetes in general practice. We published our review protocol.

The review findings show:

      • Just 9 studies were relevant.
      • 5 involved assessing depressive symptoms only, 2 assessed diabetes distress only, and 2 assessed both.
      • 5 of the 7 studies showed a benefit, i.e., reduction in depressive symptoms or diabetes distress.
      • In each study, the PROM responses were collected and returned to a healthcare professional. However, most studies needed research staff to collect the PROM.
      • Most studies involved complex actions based on the PROM responses. For example, one study used telephone coaching sessions. Another involved case managers to deliver tailored care

This review shows there are benefits to using PROMs. But it also shows that assessing and addressing these issues takes resources that don’t exist in general practice. We suggest that future research needs to:

      • explore the most efficient actions based on the PROM responses.
      • examine the options for using technology for PROM collection in general practice.

For more about Dr Rita McMorrow’s research about diabetes distress in general practice, check out this ACBRD webinar.


Reference: McMorrow R, Hunter B, Hendrieckx C, Kwasnicka D, Speight J, Cussen L, Ching Siew Ho F, Emery J, Manski-Nankervis J. Effect of routinely assessing and addressing depression and diabetes distress on clinical outcomes among adults with type 2 diabetes: A systematic review. BMJ Open, 2022; 12(5): e054650

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