Objectives: This study seeks to understand the information needs of people with diabetes aged 65 and older gathered through survey and focus groups to inform development of an educational decision aid, SEE-Diabetes (Support-Engage-Empower-Diabetes). The SEE-Diabetes aid provides patient-centered self-management education and support for older people with diabetes.
Methods: We surveyed 82 University of Missouri Health Care patients with diabetes Thirty seven surveys were completed. The survey collected demographics, diabetes duration, insulin usage, and the accessibility of clinic notes through a patient portal. For focus groups, nine participants aged 65 and over accepted an invitation to participate. We asked participants to evaluate three randomly selected deidentified representative clinic notes to assess readability and helpfulness. We demonstrated the SEE-Diabetes aid and asked participants’ opinions. Thematic analysis was used to analyze qualitative data.
Results: Most survey participants’ providers were from diabetes specialty care (31, 84%). The mean age of participants was 66 (24–82, SD=12), and 22 participants were females (60%). Mean diabetes duration was 20.9 years (0–63, SD=15). Twenty-eight participants (76%) accessed their medical records, and most (29, 78%) have read their clinical notes. In the focus groups, the readability of clinic notes was noted as a primary concern because of medical abbreviations and poor formatting. Participants found that the helpfulness of clinic notes was negatively impacted by non-specific and insufficient self-care information.
Conclusion: This study identified the context of use and user requirement. We found that most participants have read their clinic notes using the patient portal, which offers a use case opportunity for the proposed SEE-Diabete aid. Feedback about the readability and helpfulness of clinic note will be considered during the design process. For further study, we will iteratively evaluate the readability and usability of the SEE-Diabetes aid.
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