Considering the patient perspective for assessing the outcomes of diabetes lifestyle modification programmes: what should we measure,and how?

Abstract

Current evidence shows that type 2 diabetes can be effectively prevented and delayed by lifestyle modification. After careful development and pilot testing, a rigorous evaluation of such programmes is crucial to assess their effectiveness prior to large scale implementation. Integrating the patient perspective in this evaluation is essential. In principle, Patient-Reported Outcomes (PRO) questionnaires can address this key question. However, researchers and clinicians lack a clear framework to make a sound selection of appropriate measures among the large set of possible questionnaires. As a consequence, it is unclear what is the most useful information to be captured from patients when assessing a new programme, so that it can be determined whether the programme can be generalised to a larger population: is it health-related quality of life, satisfaction or something different which could predict the long-term success of the programme? We recommend a specific approach, better adapted to the nature of the intervention, and suggest a selection of a few existing PRO measures that could satisfy the requirements.