Implementing shared-decision-making for diabetes care across country settings: What really matters to people?

Abstract

(Word number: 250)Diabetes is one of the leading causes of mortality, disability and expenditure worldwide. Growing evidence of improved outcomes (patient/professional satisfaction and some evidence on controlled weight, blood glucose and blood pressure) supports shareddecision-making (SDM) as an effective primary care intervention for diabetes. However, only a few countries have actually adopted it (e.g. UK). In other European countries there is awareness that patients play a crucial role in decision-making, and SDM policies could be considered as innovative strategies to promote the actual implementation of patient rights legislation and strengthen primary care (e.g. Cyprus). Objective of this research was to inform the development and testing of a tool to value patients' preferences for SDM model across different European settings: UK, where SDM is already in place at a national level, and we can draw from people direct experience; Cyprus, where people are new to it, although there could be room for future implementation. In doing so the study used a discrete-choice-experiment (DCE) survey. The DCE survey presents a series of choices involving alternative services on offer, described by their particular characteristics. It allows to: identify the characteristics of the health care service that respondents value; the relative values that they attach to these; and the trade-offs between them (e.g. how long patients are willing to wait to receive detailed and accurate information about their care). Data collection is under way and findings will be available for discussion at the meeting. They will inform the development of a larger European programme of research.

Averting multiple sclerosis long-term societal and healthcare costs: The Value of Treatment (VoT) project

“…An health economic technique, such discrete choice experiments (Clark MD, et al 2014) could find a new use to support the development of person-centered care pathways in MS according to patient preferences and experience of care (Anagnostou D, et al 2017). A DCE-based patient relevant outcome indicator could also be developed and applied to evaluate the benefits attached to new person-centered care pathways compared to current care (for example see application to diabetes (Tinelli M, et al 2017) and also monitor their performance (alongside other clinical and health status indicators) against defined benchmarks (Tinelli M, et al 2016).…”

Making Use of Comparable Health Data to Improve Quality of Care and Outcomes in Diabetes: The EUBIROD Review of Diabetes Registries and Data Sources in Europe

“…However, the situation is improving and clinical data should be rapidly made available ( 32 ). On the other hand, electronic health records collected at the point of care using a valid patient ID were noted in a second group of participants from Belgium ( 36 ), Cyprus ( 37 ), England ( 30 ), Italy ( 31 ), Malta ( 38 ), Poland ( 39 ), Romania ( 40 ) and Slovenia ( 41 ). For England, the advantages offered by an expanding network of general practitioners included the possibility of linking and comparing items from different comorbid conditions stored in the same database ( 42 ).…”

Improving quality care for diabetes in the community: What do Cypriot patients want?

“…When comparing Cyprus to an alternative European setting such as England where person centred practices are already in place we found that Cypriots valued choosing alternative SDM services compared to their 'current' option, whereas the English preferred their status quo to other services. 36 Several of these issues can be imputed to the lack of a universal coverage system. Indicatively, patient campaigns, medical audit and other efficiency enhancement activities such as electronic prescribing, performance management have been programmed once the NHIS is on, therefore is anticipated that this will address, at least to a certain degree some of our findings.…”