title: Breaking Barriers to Effective Type 2 Diabetes Management: Findings from the use of the OPTIMA© Questionnaire in Clinical Practice.
abstract: The OPTIMA© (MSD, Courbevoie, France) questionnaire was developed to promote shared decisions and the set-up of specific micro-objectives in clinical practice by optimizing communication between type 2 diabetes (T2DM) patients and their physicians. The present study aimed to assess OPTIMA in clinical practice.
  
  
  
  A cross-sectional multicenter observational study was conducted in France from 2012 to 2014. During routine consultation, patients completed one of the five modules of the OPTIMA questionnaire (Physical activity, Diet, Treatment, Knowledge of the disease or Self-monitoring of blood glucose). The rate of SMART (specific, measurable, acceptable, realistic, timely) micro-objective set-up following the use of the questionnaire was assessed. Data on how patients felt about their diabetes management (beliefs concerning actions, how easy they were to do and how often they were done in practice) were gathered. Finally, patients' and physicians' opinions on OPTIMA were assessed using the PRAgmatic Content and face validity Test (PRAC-Test© (Mapi, Lyon, France) evaluation questionnaire.
  
  
  
  Overall, 807 patients were included by 186 physicians. While 92.7 % of consultations led to the set-up of a micro-objective, only 22.3 % were SMART micro-objectives: Physical activity module (34.3 %), Diet module (9.6 %), Treatment module (16.4 %), Knowledge of the disease module (25.2 %), and self-monitoring of blood glucose module (29.5 %). Among patients completing the Physical activity module, 79.0 % reported that they believed physical activity was useful, 35.0 % that it was easy, and 25.8 % that they regularly practised it. PRAC-Test results showed that OPTIMA was a useful and easy-to-use questionnaire that promotes communication between physicians and their patients according to 92.8 % of patients and 69.4 % of physicians.
  
  
  
  The OPTIMA questionnaire facilitates communication between patients and their physicians and promotes the set-up of micro-objectives concerning T2DM management. The Physical activity module was the most likely of the five modules in the questionnaire to lead to the set-up of SMART micro-objectives.
  
  
  
  MSD France.
authors.affiliation: Service de diabétologie, Institut E3M, Hôpital Pitié-Salpêtrière, Paris, France.
authors.forename: André
authors.initials: A
authors.lastname: Grimaldi
authors.affiliation: Service d'endocrinologie, diabétologie et maladies métaboliques, Centre Hospitalier Sud-Francilien de Corbeil-Essonnes, Université Paris-Sud, Orsay, France.
authors.forename: Alfred
authors.initials: A
authors.lastname: Penfornis
authors.affiliation: Université Paris Descartes, Service de Psychiatrie de l'Adulte et du Sujet Agé, Hôpitaux Universitaires Paris Ouest, Paris, France.
authors.forename: Silla
authors.initials: S
authors.lastname: Consoli
authors.affiliation: Université de Médecine Paris-Sud, Ecole de Santé Publique Paris-Sud, INSERM U669, Paris, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Falissard
authors.affiliation: MSD, Medical Department, Courbevoie, France.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Eymard
authors.affiliation: Mapi, Patient-Centered Outcomes, Lyon, France.
authors.forename: Paul
authors.initials: P
authors.lastname: Williams
authors.affiliation: MSD, Medical Department, Courbevoie, France. sylvie.dejager@merck.com.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Dejager
mesh_terms: D000368:Aged; D003144:Communication Barriers; D003430:Cross-Sectional Studies; D003657:Decision Making; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010346:Patient Care Management / Q000379:methods / Q000592:standards; D010358:Patient Participation; D010817:Physician-Patient Relations; D058996:Quality Improvement; D011795:Surveys and Questionnaires / Q000592:standards
keywords: Clinical practice; OPTIMA questionnaire; SMART micro-objective; Shared decision-making; Type 2 diabetes