{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T15:01:58Z","timestamp":1785164518268,"version":"3.55.0"},"reference-count":35,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"unspecified","delay-in-days":26,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014467","name":"Western Sydney Local Health District","doi-asserted-by":"publisher","award":["NA"],"award-info":[{"award-number":["NA"]}],"id":[{"id":"10.13039\/100014467","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,7,14]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To codesign a preclinic Diabetes Priorities Questionnaire (DPQ) tool for people with type 2 diabetes and healthcare professionals to identify patient needs in advance and enable efficient, patient-centred consultations for diabetes management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Participatory approach using codesign focus groups to explore perspectives and develop solutions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>This study was conducted in Western Sydney, Australia, an area with high socioeconomic disadvantage and cultural diversity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>10 adults with type 2 diabetes and 8 healthcare providers including specialists, diabetes educators, general practitioners, dietitians and pharmacists were recruited from a public hospital-based outpatient diabetes service and community-based providers in Western Sydney.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The codesign process was employed to iteratively develop and refine the DPQ. Focus groups were conducted in a hybrid format including in person and online, using semistructured discussions on four key topics: (1) understanding the purpose of the tool, (2) usability of the tool, (3) perceived benefits of completing the tool and (4) asking the right questions (content). Participants were invited to review and provide feedback on the initial set of questions, with the aim of identifying key challenges and potential solutions to enhance the content and uptake of the tool. Feedback was collected through audio recordings and field notes. These insights informed successive revisions of the DPQ following each round of focus groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five focus groups involving 18 participants identified opportunities to improve the initial questions by restructuring their order, simplifying the content and incorporating concerns about diabetes complications, including mental health. Participants highlighted the importance of holistic care and the need for both digital and paper-based formats to enhance accessibility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The final DPQ was digitised within a patient care portal and integrated with tailored diabetes educational content. By enabling preconsultation screening, the codesigned DPQ supports multidisciplinary teams in delivering patient-centred care. Further research is needed to assess the tool\u2019s impact on clinical outcomes, patient satisfaction and healthcare efficiency.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-109436","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T14:35:36Z","timestamp":1785162936000},"page":"e109436","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Diabetes Priorities Questionnaire (DPQ): a codesigned preclinic priority setting tool to enable patient-centred care for people with type 2 diabetes"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1097-0671","authenticated-orcid":false,"given":"Sumathy","family":"Ravi","sequence":"first","affiliation":[{"name":"Western Sydney Diabetes, Integrated and Community Health, Western Sydney Local Health District, Blacktown, New South Wales, Australia"},{"name":"Sydney Health Literacy Lab, Sydney School of Public Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia"},{"name":"Leeder Centre for Health Policy, Economics and Data, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5279-5189","authenticated-orcid":false,"given":"Julie","family":"Ayre","sequence":"additional","affiliation":[{"name":"Sydney Health Literacy Lab, Sydney School of Public Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaybee","family":"Serrano","sequence":"additional","affiliation":[{"name":"Western Sydney Diabetes, Integrated and Community Health, Western Sydney Local Health District, Blacktown, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1725-7094","authenticated-orcid":false,"given":"Glen","family":"Maberly","sequence":"additional","affiliation":[{"name":"Western Sydney Diabetes, Integrated and Community Health, Western Sydney Local Health District, Blacktown, New South Wales, Australia"},{"name":"Sydney Health Literacy Lab, Sydney School of Public Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2696-5006","authenticated-orcid":false,"given":"Kirsten","family":"McCaffery","sequence":"additional","affiliation":[{"name":"Sydney Health Literacy Lab, Sydney School of Public Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carissa","family":"Bonner","sequence":"additional","affiliation":[{"name":"Sydney Health Literacy Lab, Sydney School of Public Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia"},{"name":"Leeder Centre for Health Policy, Economics and Data, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"2026072707352998000_16.7.e109436.1","doi-asserted-by":"crossref","unstructured":"Sun H , Saeedi P , Karuranga S , et al . IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract 2022;183. doi:10.1016\/j.diabres.2021.109119","DOI":"10.1016\/j.diabres.2021.109119"},{"key":"2026072707352998000_16.7.e109436.2","unstructured":"International Diabetes Federation. IDF Diabetes Atlas . IDF Diabetes Atlas, 11th edn. Brussels, Belgium, 2025. Available: https:\/\/www.diabetesatlas.org"},{"key":"2026072707352998000_16.7.e109436.3","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1007\/s00125-020-05319-w","article-title":"Impact of age at type 2 diabetes mellitus diagnosis on mortality and vascular complications: systematic review and meta-analyses","volume":"64","author":"Nanayakkara","year":"2021","journal-title":"Diabetologia"},{"key":"2026072707352998000_16.7.e109436.4","doi-asserted-by":"publisher","DOI":"10.2337\/dc16-S004"},{"key":"2026072707352998000_16.7.e109436.5","doi-asserted-by":"crossref","unstructured":"Goodwin N , Stein V , Amelung V . What is integrated care. In: Amelung V , Stein V , Suter E , et al ., eds. Handbook integrated care. Cham: Springer International Publishing, 2021: 3\u201325.","DOI":"10.1007\/978-3-030-69262-9_1"},{"key":"2026072707352998000_16.7.e109436.6","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.colegn.2017.02.005","article-title":"Patient-centred care as an approach to improving health care in Australia","volume":"25","author":"Jo Delaney","year":"2018","journal-title":"Collegian"},{"key":"2026072707352998000_16.7.e109436.7","doi-asserted-by":"crossref","DOI":"10.5334\/ijic.6025","article-title":"Effectiveness of Integrated Diabetes Care Interventions Involving Diabetes Specialists Working in Primary and Community Care Settings: A Systematic Review and Meta-Analysis","volume":"22","author":"Zarora","year":"2022","journal-title":"Int J Integr Care"},{"key":"2026072707352998000_16.7.e109436.8","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1108\/JICA-09-2017-0029","article-title":"Effectiveness of joint specialist case conferences for building general practice capacity to enhance diabetes care","volume":"26","author":"Meyerowitz-Katz","year":"2018","journal-title":"JICA"},{"key":"2026072707352998000_16.7.e109436.9","unstructured":"Organization WH . Continuity and coordination of care: a practice brief to support implementation of the WHO Framework on integrated people-centred health services. 2018."},{"key":"2026072707352998000_16.7.e109436.10","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/j.cct.2016.01.012","article-title":"Pre-Visit Prioritization for complex patients with diabetes: Randomized trial design and implementation within an integrated health care system","volume":"47","author":"Grant","year":"2016","journal-title":"Contemp Clin Trials"},{"key":"2026072707352998000_16.7.e109436.11","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.pec.2017.07.016","article-title":"A disease-specific questionnaire for measuring patient-reported outcomes and experiences in the Swedish National Diabetes Register: Development and evaluation of content validity, face validity, and test-retest reliability","volume":"101","author":"Svedbo Engstr\u00f6m","year":"2018","journal-title":"Patient Educ Couns"},{"key":"2026072707352998000_16.7.e109436.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2007.12.020"},{"key":"2026072707352998000_16.7.e109436.13","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.20.5.760"},{"key":"2026072707352998000_16.7.e109436.14","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.18.6.754"},{"key":"2026072707352998000_16.7.e109436.15","doi-asserted-by":"crossref","unstructured":"Sorrell S . Digital technologies for the assessment, diagnosis, and treatment of diabetes distress: A review of current evidence. Health Sciences Review 2025;15. doi:10.1016\/j.hsr.2025.100227","DOI":"10.1016\/j.hsr.2025.100227"},{"key":"2026072707352998000_16.7.e109436.16","doi-asserted-by":"crossref","DOI":"10.2196\/jmir.1733","article-title":"Impact of length or relevance of questionnaires on attrition in online trials: randomized controlled trial","volume":"13","author":"McCambridge","year":"2011","journal-title":"J Med Internet Res"},{"key":"2026072707352998000_16.7.e109436.17","doi-asserted-by":"crossref","first-page":"214","DOI":"10.34172\/jcs.33287","article-title":"Survey Fatigue in Questionnaire Based Research: The Issues and Solutions","volume":"13","author":"Ghafourifard","year":"2024","journal-title":"J Caring Sci"},{"key":"2026072707352998000_16.7.e109436.18","first-page":"22","article-title":"Hospital Specialists join the GP Team: Virtual clinics to manage T2D","volume":"2022","author":"Maberly","year":"2022","journal-title":"Diabetes Management Journal"},{"key":"2026072707352998000_16.7.e109436.19","doi-asserted-by":"crossref","first-page":"412","DOI":"10.5334\/ijic.ICIC24189","article-title":"Asking The Right Questions: Co-designing a pre-consultation assessment tool to meet the needs of people with diabetes in Western Sydney","volume":"25","author":"Ravi","year":"2025","journal-title":"Int J Integr Care"},{"key":"2026072707352998000_16.7.e109436.20","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-024-76584-7","article-title":"One-year outcomes of a digital twin intervention for type 2 diabetes: a retrospective real-world study","volume":"14","author":"Shamanna","year":"2024","journal-title":"Sci Rep"},{"key":"2026072707352998000_16.7.e109436.21","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1080\/15710882.2014.888183","article-title":"Probes, toolkits and prototypes: three approaches to making in codesigning","volume":"10","author":"Sanders","year":"2014","journal-title":"CoDesign"},{"key":"2026072707352998000_16.7.e109436.22","unstructured":"Australian Bureau of Statistics . Census of Population and Housing. Canberra: ABS, 2021. Available: https:\/\/www.abs.gov.au\/census"},{"key":"2026072707352998000_16.7.e109436.23","doi-asserted-by":"crossref","first-page":"e68","DOI":"10.1016\/j.diabres.2014.09.033","article-title":"Understanding geographical inequities in diabetes: multilevel evidence from 114,755 adults in Sydney, Australia","volume":"106","author":"Astell-Burt","year":"2014","journal-title":"Diabetes Res Clin Pract"},{"key":"2026072707352998000_16.7.e109436.24","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-6-42"},{"key":"2026072707352998000_16.7.e109436.25","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1111\/jdi.14051","article-title":"Validity of the short-form five-item Problem Area in Diabetes questionnaire as a depression screening tool in type\u20092 diabetes mellitus patients","volume":"14","author":"Tay","year":"2023","journal-title":"J Diabetes Investig"},{"key":"2026072707352998000_16.7.e109436.26","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1093\/tbm\/ibx086","article-title":"Information technologies that facilitate care coordination: provider and patient perspectives","volume":"8","author":"Dixon","year":"2018","journal-title":"Transl Behav Med"},{"key":"2026072707352998000_16.7.e109436.27","doi-asserted-by":"crossref","DOI":"10.5334\/ijic.5573","article-title":"Co-Design for People-Centred Care Digital Solutions: A Literature Review","volume":"21","author":"Sanz","year":"2021","journal-title":"Int J Integr Care"},{"key":"2026072707352998000_16.7.e109436.28","doi-asserted-by":"publisher","DOI":"10.1111\/dme.14199"},{"key":"2026072707352998000_16.7.e109436.29","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-2493"},{"key":"2026072707352998000_16.7.e109436.30","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13448"},{"key":"2026072707352998000_16.7.e109436.31","doi-asserted-by":"publisher","DOI":"10.1111\/dme.14157"},{"key":"2026072707352998000_16.7.e109436.32","doi-asserted-by":"crossref","first-page":"493","DOI":"10.4314\/ajhs.v36i5.2","article-title":"Clinicians\u2019 Barriers to Screening and Diagnosing Diabetes Distress in Patients with Type 1 and 2 Diabetes Mellitus: A systematic review","volume":"36","author":"Nhlabatsi","year":"2023","journal-title":"AJHS"},{"key":"2026072707352998000_16.7.e109436.33","unstructured":"Serrano J , Bramwell S , Dick H , et al . Integrating Digital Diabetes Patient Survey for Enhanced Patient-Centred Care: A Collaborative Approach. Australasian Diabetes Congress 2024."},{"key":"2026072707352998000_16.7.e109436.34","doi-asserted-by":"crossref","unstructured":"Australian Institute of Health Welfare . Australia\u2019s health 2018. Canberra: AIHW, 2018.","DOI":"10.21820\/23987073.2018.2.80"},{"key":"2026072707352998000_16.7.e109436.35","doi-asserted-by":"crossref","first-page":"2263355","DOI":"10.1080\/28355245.2023.2263355","article-title":"Artificial intelligence and health literacy\u2014proceed with caution","volume":"1","author":"Nutbeam","year":"2023","journal-title":"Health Literacy and Communication Open"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-109436","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T14:35:41Z","timestamp":1785162941000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-109436"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":35,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,27]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/bmjopen-2025-109436"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-109436","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}