VOIES-D-ql - Qualitative Study on Experiences of Diabetes Care Delivery and Planning
VOIES-D-ql - Qualitative Study on Experiences of Diabetes Care Delivery and Planning
Population aging and the increase in incidence and prevalence of potentially disabling
 chronic conditions make health care more and more complex and costly. In this context,
 timelines are longer and adherence to care provision and health status are more variable -
 both within and between patients - and care is provided by different health care
 professionals, as well as services outside the health system, which may work at various
 levels of service integration. For diabetes, this is especially the case: patients at high
 risk for multimorbidity interact with multiple health care professionals, such as primary
 care physicians, diabetes specialists, nurses, nutritionists and therapeutic educators, with
 different perspectives to treatment. The patient is frequently the only link between the
 different health care professionals, and very often the main source of information regarding
 performed procedures, diagnoses and treatment decisions.

 A current challenge facing all health care stakeholders, including policy makers,
 practitioners, businesses, and patients, is to coordinate the available services and
 integrate care ensuring safety, effectiveness, and comprehensiveness in relation to the needs
 of individual users across the lifespan. Routine collected data can provide key information
 to completely assess a patient's health status and thus help evaluating and deciding adapted
 steps in treatment to stabilize or improve clinical outcomes.

 In France, the Dossier Medical Partagé (Shared Medical Record) represents an effort to
 centralize and improve accessibility, to patients and professionals alike, of medical
 information. This system is yet little adopted and there is the need for added value
 initiatives to exploit the tool's potential. In other countries, like the UK, the
 governmental unit NHSX develops public policies and good practices for the digital
 transformation of the NHS. In the United States, working groups like the Health Information
 Technology Working Group, in the National Institute of Diabetes and Digestive and Kidney
 Diseases, develop electronic care plans using Electronic Health Record data for chronic
 kidney disease patients. These initiatives, among others, show the necessity of simple,
 visual communication in order to build a comprehensive care delivery pathway to inform
 decision and further care planning, according to health goals set by shared decision-making.

 This study aims to describe individual experiences of chronic care delivery of people living
 with diabetes and also from healthcare professionals working in diabetes care from 3
 different domains: clinical (relevant clinical criteria necessary for the decision-making
 process, goal setting and planning), technological (tools used in routine practice and in
 patients' daily lives), and behavioural (behaviours and interactions that build the patient's
 pathway and strategies implemented by patients and professionals to help the decision-making
 process).

 Locations of the study : Primary and secondary healthcare facilities and patient associations
 in Lyon and Grenoble areas
Inclusion Criteria:

 Patient

 -  At least 18 years old

 -  Diagnosed with type 1 or type 2 diabetes according to HAS criteria and confirmed by
 and endocrinologist since at least one year

 -  Having had at least one consultation with a health care professional in the last 12
 months

 -  Able to communicate in French

 -  Able to participate in an interview and not opposing to participate in the study

 Professional

 -  Having at least one year of professional experience in diabetes care

 -  General practitioner, endocrinologist, diabetologist, intern, nurse, nutritionist or
 professional specialized in therapeutic education

 Exclusion Criteria:

 Patient

 -  Inability to communicate in French

 -  Institutionalized person

 Professional

 -  Professional not having had at least one consultation with a person living with
 diabetes in the last 12 months