Plain English Summary
Background and study aims
Diabetes is a long-term condition suffered by an increasing number of people around the world. It is a major challenge for healthcare services, being the single biggest cause of stroke, blindness, amputation and end stage kidney failure. Its cost will be severely challenging for the National Health Service (NHS) in the UK (already 10% of the budget).
Self-management of diabetes is an essential factor in achieving target blood glucose levels and avoiding future complications. The aim of this study is to understand the attributes that are deemed most important by patients and members of the general public in the self-management of diabetes. Knowing this will help healthcare providers design future treatments in a better way.
Who can participate?
Adults diagnosed with type 1 or type 2 diabetes mellitus.
What does the study involve?
Sheffield-based adult diabetes patients are invited to take part in individual semi-structured qualitative interviews. After consenting, participants will answer a series of questions to help the research team identify the attributes of self-management that they see as essential. Information on the significance of each attribute and possible trade-offs in self-management will also be explored.
Information from the interviews will inform the design of an online survey, presented to two invited groups, one of individuals with diabetes and another of members of the general public.
What are the possible benefits and risks of participating?
This survey will present a series of comparison questions explaining the key features of two health states and asking which is preferred. Information from this survey will be used to quantify preferences in self-management of diabetes and assign a quality adjusted life years (QALY) value and a monetary value for use in willingness to pay analysis.
There are no risks to participants.
Where is the study run from?
University of Sheffield (UK)
When is the study starting and how long is it expected to run for?
May 2014 to December 2015.
Who is funding the study?
The Health Foundation (UK)
Who is the main contact?
Martin Fox, study coordinator
Sponsor ref.: STH 18354 Funder ref.: 7265
Evaluating Self -Management in Diabetes: an observational cohort study
Self-management is key in achieving and maintaining blood glucose control in diabetes, but research centred on clinical outcomes has largely ignored how individuals with diabetes value self-management. Quantified values for self-management can be used to inform health technology assessment of self-management interventions, such as DAFNE, DESMOND and their derivatives. This study will seek to:
1. Derive up to 3 multilevel attributes for each type of diabetes that reflects self-management in type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) patients using: existing evidence in the literature on self-management in T1DM and T2DM, and qualitative work with patients
2. Estimate the value of self-management in T1DM and in T2DM in comparison to standard care both in QALY terms and monetary terms
3. Estimate the relative value of each of the attributes of self-management identified for T1DM and T2DM patients in comparison to health-related quality of life (HRQOL)
4. Recommend how these results can inform health technology assessment of self-management in T1DM patients and T2DM patients and the implementation of self-management both in T1DM, T2DM and other conditions
Recruitment end date extended to 31st October 2015 (previously 31st July 2015).
NHS Health Research Authority, NRES Committee London - Bromley, 17/07/2014, REC ref.: 14/LO/1334
An observational cohort study: 1. development 2. management 3. analysis of a Discrete Choice Experiment with diabetes patients. Duration is 14 months
Primary study design
Secondary study design
Quality of life
Patient information sheet
Type 1 and Type 2 Diabetes Mellitus
Stage 1: Deriving the attributes and levels for the DCE:
• A literature review will examine attributes related to self-management valued by individuals with diabetes
• Semi-structured interviews with diabetes patients will explore the severity levels of the proposed self-management attributes and determine whether these attributes are appropriate and sufficient (20-40 participants)
Stage 2: Online DCE survey:
This stage will value the attributes derived in stage 1 using two approaches: valuation of self-management in Quality of Life Year (QALY) terms and valuation of self-management in monetary terms. The DCE survey will use two different formats:
• combining the attributes derived in stage 1 with a duration attribute
• combining the attributes derived in stage 2 with a cost attribute
Each respondent will complete a survey online in only one format.
Sample size for the DCE:
• Up to 350 individuals with T1DM
• Up to 350 individuals with T2DM
• Up to 2000 members of the general public who do not have diabetes
Stage 3: Analysis:
Results from the DCE survey will be analysed using regression analysis to produce QALY and monetary values for the attributes of self-management. Findings will be circulated to internal and external experts, The Health Foundation and other stakeholders for comments before final reporting.
Primary outcome measures
To estimate the value of self-management for patients with T1DM and with T2DM in comparison to standard care in both QALY and monetary terms, by discrete choice experiment (DCE) questionnaire survey during May/June 2015
Secondary outcome measures
1. To derive up to 3 multilevel attributes for each type of diabetes that reflects self-management in T1DM and T2DM patients using: existing evidence in the literature on self-management in T1DM and T2DM, and the qualitative work with patients
2. To estimate the relative value of each of the attributes of self-management identified for T1DM and T2DM patients in comparison to health-related quality of life (HRQOL)
3. To recommend how these results can inform health technology assessment of self-management in T1DM patients and T2DM patients and the implementation of self-management both in T1DM, T2DM and other conditions.
Overall trial start date
Overall trial end date
Participant inclusion criteria
1. Patients diagnosed with type 1 or type 2 diabetes mellitus
2. Patients who are aged 18+ years when taking part in this study
3. Patients who are fluent in English
Target number of participants
Participant exclusion criteria
To ensure informed consent potential participants must have a good understanding of the English language
Recruitment start date
Recruitment end date
Countries of recruitment
Trial participating centre
University of Sheffield
The Health Foundation (UK)
Funding Body Type
Funding Body Subtype
Results and Publications
Publication and dissemination plan
Reporting of findings expected from October 2015.
Intention to publish date
Participant level data
Stored in repository
Results - basic reporting