864-P: Treatment Burden and Quality of Life Conversations during Clinical Encounters: A Videographic Analysis

Aim: Patients with diabetes mellitus (DM) experience significant burden of disease and poorer quality of life compared with patients without diabetes. Yet, data on how these aspects are raised, discussed, and addressed during clinical encounters are sparse. We aimed to analyze the nature of discussions about quality of life (QoL), treatment burden (TB), hypoglycemia, sexual function, and social support during clinician-patient encounters focused on diabetes care. Methods: A total of 41 previously recorded patient-clinician encounters were used for videographic analysis. Encounters were recorded primarily from family medicine and internal medicine clinics, and all patients had a diagnosis of DM. Two coders analyzed the videos for discussions about QoL, TB, hypoglycemia, sexual function, and social support using an a priori developed codebook that defined the domains. When a topic was raised, coders evaluated the nature of the conversation, provider response, time spent on topic, and any solutions proposed by the clinician. Results: Of the 41 videos analyzed, 85.4% included some discussion regarding QoL (58.5%), TB (51.2%), social support (9.8%) or hypoglycemia (2.4%). Sexual function was not brought up in any of the encounters. On average, 15% of the clinical encounter time was spent on QoL, TB, social support, or hypoglycemia. In contrast, 4.5% of the encounter focused on HbA1c. When an aspect arose within the encounter, clinicians acknowledged the patient’s concern without providing a solution in 45.8% of the cases. Conclusion: Consistent with patient experiences, we found that a significant portion of clinical encounters conversations were devoted to QoL and TB, with a greater amount of time spent on these than HbA1c goals. Yet, when these topics arose during encounters, solutions were seldom provided. Sexual dysfunction, a common complication of DM, was not discussed in our sample. Disclosure S. Haider: None. O. M. El kawkgi: None. J. Clark: None. M. Breslin: None. K. Boehmer: None. V. M. Montori: None. K. J. Lipska: None.