882-P: QBSAFE: Pilot Study of an Intervention to Shift the Paradigm of Diabetes Care

Background: Diabetes care has traditionally focused on targeting certain levels of glycemic control. This narrow emphasis may impose burdens on patients, including high treatment costs, illness-related work, or medication side effects, while leaving other needs and goals under-addressed. Methods: In order to shift the focus of care for people with diabetes to Quality of life, Burden of treatment, Safety, and Avoidance of Future Events (QBSAFE), we developed a set of 14 conversation cards that addressed these QBSAFE domains and could be used during routine clinical encounters. We then conducted a single-arm pilot study assessing the feasibility and acceptability of the QBSAFE cards during clinical visits. Visits were video recorded to identify patterns of clinician-patient conversations. Post-visit surveys were sent to patients and clinicians to measure acceptability of the intervention. Qualitative semi-structured interviews for additional feedback and analysis were also performed in a subgroup of patients. Results: Seven clinicians and 83 patients (54% male, mean age 63 years [SD 15], 80% white) participated in the study. Among patient participants, 63% reported QBSAFE cards were helpful and 76% felt that other patients like them would benefit from their use. In qualitative interviews, patients who responded with ‘neutral’ or ‘disagree’ categories reported feeling they could bring up QBSAFE topics without the cards due to an established, positive relationship with their clinician. Among clinician participants, 90% reported feeling confident addressing issues raised by the cards, 78% would use them again, and 82% would recommend them to their colleagues. Discussion: With high acceptability among clinicians and patients, the QBSAFE cards have the potential to shift conversations during clinical encounters and address patient needs, symptoms, and capacity. These data suggest that a clinician-level cluster randomized trial to compare the impact of this intervention versus usual care is needed. Disclosure J. Clark: None. V. M. Montori: None. K. J. Lipska: None. K. Boehmer: None. M. Breslin: None. S. Haider: None. W. Pasciak: None. D. Gravholt: None. B. B. M. Sanchez: None. S. A. Hartasanchez: None. O. M. El kawkgi: None. Funding National Institute on Aging (5R21AG061427-02)