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074 FORAIDMUCO: Implementation of a shared decision-making intervention in the treatment of diabetes in adult patients with cystic fibrosis: a here and elsewhere qualitative evaluation
  1. Nora Moumjid1,2,3,
  2. Constance Varoquier4,
  3. Sophie Hommey4,
  4. Stéphanie Poupon4,
  5. Isabelle Durieu1,4,5,
  6. Julie Haesebaert4,5,
  7. Quitterie Reynaud1,4,5
  1. 1lyon 1 Claude Bernard University, Lyon, France
  2. 2p2s Ur 4129, Lyon, France
  3. 3Centre Léon Bérard, Lyon, France
  4. 4Hospices Civils De Lyon, Lyon, France
  5. 5RESHAPE INSERM U1290

Abstract

Introduction Cystic fibrosis diabetes affects half of cystic fibrosis patients over the age of 30 and evolves asymptomatically during a long time. Two options are possible: start insulin treatment as soon as the HGPO screening test is positive or later when the patient develops symptoms. In practice, this takes place without a formalized process of shared decision making (SDM) between the physician-medical team and the patient.

Objectives To train Cystic Fibrosis Reference Centers’ (CFRC) teams in SDM, implement a formalized SDM program for the treatment of cystic fibrosis-related diabetes and evaluate it from caregivers’ and patients point of views.

Methods Multicentric here and elsewhere study comparing 3 CFRCs trained in SDM through e-learning plus coaching and, for implementation, patient activation (poster), to 2 CRFCs without SDM training and without patient activation.

Evaluation in all CRCMs based on mixed methods combining: (i) observations of consultations; (ii) individual semi-structured interviews with patients to analyze their experience of decision-making; (iii) questionnaires administered to patients to measure SDM, their knowledge, decision-making conflict, anxiety as well as to physicians; (iv) focus groups with CFRCs teams to analyze their experience of decision-making modalities (SDM vs. no SDM).

Individual semi-structured individual interviews will also be conducted with hospital managers to assess the place of patient partnership and SDM in hospital policy and practice.

Expected Results SDM adoption evaluation and its effects on the patient, the physician and the teams; experience of SDM implementation by the patient and the CRFCs teams; and the place of patient partnership and SDM in hospitals.

Discussion The proposed approach will provide patients and CRFCs teams with a formalized SDM approach aimed at enabling them to take together, if they wish so, the best decision for the patient, thus improving quality and experience of care for all.

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