Endocrine Abstracts

Agenda Setting Tools (AST) help doctors and patients identify topics for discussion at OPD. ASTs can enhance interactions between Healthcare Professional’s (HCP’s) and patients, and promote shared-decision making. Patients (aged≥ 18 years) attending T1D clinics completed the AST. HbA1c levels were taken on the day of consultation. Semi-structured interviews were carried out on patients and HCP’s who used the tool. Data analysis was carried out using Microsoft Excel and SPSS®27 (SPSS Inc., Chicago, Illinois, USA). 94 AST’s were assessed. 40 patient completed feedback questionnaires. Mean HbA1c was 62 mmol/mol. 38% of patients experienced elevated distress (DDS2 ≥3), of whom 37% were referred for psychological evaluation. 80% found discussing DD beneficial. Positive correlation was found between DD and HbA1c (r = 0.45, P < 0.01) and DD and impaired hypoglycaemia awareness (r = 0.60, P < 0.001). 83% of patients rated the AST as “helpful” or “Very helpful”. “Pump/Sensor” was the most requested topic on the patient’s agenda (21%). Patients new to the diabetes service and young patients found the AST helpful for building rapport and structuring consultations. All HCP’s found the AST useful in structuring consultations and identifying patient priorities. All expressed a willingness to continue its use in clinics. Challenges identified included time constraints in busy clinics and individualized goal setting. Patients and HCP’s responded positively to the use of the AST during consultations, favouring its ability to guide discussions and encourage shared-decision making. Key learnings led to service improvements, including the development of the DD protocol and directory of support options for patients.