Feasibility Study to Assess the Incorporation of the Diabetes Distress Assessment System and Diabetes Distress Scale...

Diabetes affects nearly 25% of the Veterans Health Administration population, and a diagnosis of diabetes has been reported to increase distress in patients. This study aimed to assess the feasibility of incorporating a diabetes distress (DD) screening program in a Veterans Administration (VA) diabetes clinic and identifying opportunities for intervention.

Veterans diagnosed with diabetes attending appointments with the clinical pharmacist practitioner in the endocrinology diabetes clinic were asked to participate. Veterans diagnosed with cognitive impairment and/or unable to answer multi-part questions were excluded. Veterans who agreed to participate were asked to complete the two-question Diabetes Distress Scale (DDS2) screening tool and then complete the Type 1 Diabetes Distress Scale (T1-DDS) or the Type 2 Diabetes Distress Assessment System (T2-DDAS), if indicated.

Eighty-seven veterans were identified to complete the DD2S, and 58 (67%) agreed. The mean DDS2 score was 3.2 ± 1.3. Twenty of the 32 participants (67%) who were then offered the T1-DDS or T2-DDAS completed it. A majority of those with a score indicating at least moderate distress accepted a referral to a Whole Health health coach for follow-up.

Veterans were interested in completing the DD2S and the T1-DDS or T2-DDAS. This feasibility study was conducted to develop a foundation for larger trials to identify the optimal approach to identifying DD and providing proper referrals for interventions to address it. Successful integration of DD screening into daily clinical practice in VA clinics could improve diabetes care for veterans.