PRP022: Assessing and addressing diabetes distress in Australian general practice: protocol for a mixed methods study

Rita McMorrow, MBChB; Nana Folmann Hempler, PhD; Jo-Anne Manski-Nankervis, PhD, BSc, MBBS, FRACGP; Christel Hendrieckx; Barbara Hunter, PhD; Jane Speight


Context: Diabetes distress is the negative psychological response to the emotional burden of living with and managing diabetes. It is associated with sub-optimal glycemia and self-management. The Diabetes Attitudes, Wishes and Needs (DAWN2) study found 45% of participants reported severe diabetes distress. In the Australian Diabetes MILES- 2 survey 20% of people with type 2 diabetes (T2D) using insulin reported severe diabetes distress, as measured with the Problem Areas in Diabetes (PAID) scale. Australian and international guidelines including the American Diabetes Association recommend tools, such as PAID, to assess psychological health in people with diabetes. As most T2D care occurs in general practice, general practitioners (GPs) have a significant role to assess and address diabetes distress. Objective: To explore Australian GPs’ current practice, knowledge, opinions, and barriers and facilitators to assessing and addressing diabetes distress. To understand people with type 2 diabetes’ experiences and expectations of emotional support in general practice. This knowledge will be used to co-design solutions to address the behaviour changes needed in general practice. Study Design: Mixed methods study incorporating a survey, focus groups, interviews, and feasibility study. Setting: Australian general practices (community primary care). Population studied: Phase 1: Cross-sectional survey of Australian GPs. Phase 2: Semi-structured interviews with people with T2D. Phase 3: Focus groups with GPs, practice nurses, and diabetes educators. Phase 4: Feasibility study in general practice. Outcome Measures: Phase 1: Quantitative data of current methods, knowledge and use of the PAID scale, and barriers and facilitators to addressing diabetes distress. Phase 2: People with T2D experiences, needs and expectations of emotional support in general practice and barriers and facilitators to completing the PAID scale. Phase 3: Use identified barriers and facilitators to co-design solutions. Phase 4: Qualitative data of the acceptability and usability to GPs and people with diabetes of the solutions created in phase 3. Results: Research is in progress. The protocol will be presented. Outcome to be reported: By integrating data from people with diabetes and GPs, we will identify Australian practice in assessing and addressing diabetes distress. This new knowledge will support implementation of diabetes distress assessments in general practice.
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Meghan Gilfoyle 11/23/2020

Very interesting project - looking forward to following this work. Thanks, Meghan

Johanna Lynch 11/25/2020

HI Rita - this looks really interesting. I love your use of the word distress - not anxiety or depression!! The generalist in me is thrilled!

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