719-P: Feasibility and Acceptability of the Quality of Life, Burden of Treatment, Safety, and Avoidance of Future Events Agenda Setting Kit (QBSAFE ASK)

Objectives: Diabetes care has traditionally focused on target A1c, leaving other patient goals and needs under-addressed. We assessed the feasibility and acceptability of conversation cards (QBSAFE agenda setting kit) during routine clinic visits.

Methods: We recruited clinicians and their patients with diabetes into a single-arm intervention study. The intervention consisted of a set of 14 conversation cards (QBSAFE ASK) describing diabetes-related topics. The cards were presented to patients and asked to select 0-3 cards for discussion. Clinicians and patients completed post-encounter acceptability surveys. Feasibility was assessed based on participant enrollment, time to enrollment, and percent who completed study procedures. Encounters were recorded and analyzed to describe the cards selected and clinician responses to the cards.

Results: A total of 85 patients (63yo ± 14.7, 43.5% female, and 84.5% white) and 7 clinicians were recruited over 5 months. Among 85 patients, 68.2% completed all study procedures. Most patients (63.8%) agreed the cards helped discuss their situation, 77.6% agreed other patients could benefit from them, but only 37.9% would use the cards again. Clinicians felt confident responding to issues raised by the cards during 89.9% of encounters and would recommend the cards to their colleagues (82.4%). Based on video analysis, 83.3% of patients selected at least 1 card, with the common being “I have difficulties with diet and exercise” (34.5%). Clinicians most often responded by asking elaborating questions (81.8% of encounters) followed by change in treatment (34.5%). The tool often elicited collaborative conversations between clinicians and patients (58% of encounters).

Conclusions: QBSAFE ASK can be feasibly implemented into clinical care, is generally acceptable, and holds promise in helping patients discuss their situation with clinicians and in eliciting collaborative problem-solving.