Using Patient Feedback to Improve Communication Regarding Glycemic Control to Patients With Diabetes
| Status: | Completed |
|---|---|
| Conditions: | Diabetes |
| Therapuetic Areas: | Endocrinology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/21/2016 |
| Start Date: | October 2013 |
| End Date: | July 2015 |
Using Patient Feedback to Improve the Ways we Communicate Information Regarding Glycemic Control to Patients With Poorly Controlled Diabetes
In this two-phase mixed methods study, the investigators will first use patient feedback
from semi-structured interviews to explore the ways in which patients with diabetes
understand their diabetes and assess their disease control. The investigators will also use
these interviews to elicit patient feedback on promising alternative communication formats
to the hemoglobin A1C (A1C). In the second phase of the study, the investigators will test
new formats to communicate information regarding diabetes control to patients with poorly
controlled diabetes. This phase will be a three arm RCT comparing the effect of A1C
(standard medical information) versus two alternative formats on several participant
outcomes, primarily glycemic control at 6 months post-intervention.
from semi-structured interviews to explore the ways in which patients with diabetes
understand their diabetes and assess their disease control. The investigators will also use
these interviews to elicit patient feedback on promising alternative communication formats
to the hemoglobin A1C (A1C). In the second phase of the study, the investigators will test
new formats to communicate information regarding diabetes control to patients with poorly
controlled diabetes. This phase will be a three arm RCT comparing the effect of A1C
(standard medical information) versus two alternative formats on several participant
outcomes, primarily glycemic control at 6 months post-intervention.
The noted importance of understanding glycemic control is concerning given studies
estimating that only 25% of patients understand the hemoglobin A1C value (A1C). The A1C is a
blood test value reflecting average blood sugars over the previous 3 months and is used as
both a clinical indicator of diabetes control with guideline-set targets and as a
communication format to express level of disease control to patients.Past work has
demonstrated the potential effectiveness of translating poorly understood medical values,
like the A1C, into more universally understood forms. We believe applications can be used to
address the problem of the poorly understood A1C. This study is two-phase mixed methods
approach. We will design alternative communication formats to convey the information
provided by the A1C to patients and evaluate the effectiveness of these formats in improving
glycemic control, increasing patient understanding of their diabetes control, and altering
patient behaviors. In Phase I of the study,we will use patient feedback from semi-structured
interviews with 17-25 patients with diabetes to explore the ways in which patients assess
and gauge their diabetes control, as well as to elicit patient feedback on promising
communication formats. Potential alternative communication formats include categories
represented by color-based scales (red/yellow/green), comparisons to averages or norms,
trajectories of control over time and modified medical terminology (i.e., changing the name
of the test). In phase II, patients with poorly controlled diabetes will be randomized to
receive information on their glycemic control through one of three study arms, A1C (control)
or one of two experimental format arms (chosen based on phase I results) and the effects of
these different communication formats will be evaluated.
estimating that only 25% of patients understand the hemoglobin A1C value (A1C). The A1C is a
blood test value reflecting average blood sugars over the previous 3 months and is used as
both a clinical indicator of diabetes control with guideline-set targets and as a
communication format to express level of disease control to patients.Past work has
demonstrated the potential effectiveness of translating poorly understood medical values,
like the A1C, into more universally understood forms. We believe applications can be used to
address the problem of the poorly understood A1C. This study is two-phase mixed methods
approach. We will design alternative communication formats to convey the information
provided by the A1C to patients and evaluate the effectiveness of these formats in improving
glycemic control, increasing patient understanding of their diabetes control, and altering
patient behaviors. In Phase I of the study,we will use patient feedback from semi-structured
interviews with 17-25 patients with diabetes to explore the ways in which patients assess
and gauge their diabetes control, as well as to elicit patient feedback on promising
communication formats. Potential alternative communication formats include categories
represented by color-based scales (red/yellow/green), comparisons to averages or norms,
trajectories of control over time and modified medical terminology (i.e., changing the name
of the test). In phase II, patients with poorly controlled diabetes will be randomized to
receive information on their glycemic control through one of three study arms, A1C (control)
or one of two experimental format arms (chosen based on phase I results) and the effects of
these different communication formats will be evaluated.
For Phase I:
Inclusion Criteria:
- Adults who report a diagnosis of diabetes
Exclusion Criteria:
- People without diabetes
For Phase II:
Inclusion Criteria
-Adults seen at University of Pennsylvania primary care practice with a diagnosis of
diabetes documented in the electronic health record and a recent hemoglobin A1C >8 %
Exclusion
- No diabetes
- No A1C or recent A1C <8%
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