Improving care for sexual problems in persons with type 2 diabetes (WC2013-083)

Methods

Starting date: 01/09/2013

Design

A pragmatic, clustered randomized clinical trial in two parallel groups will be conducted. The inclusion criteria are men and women aged 40-75 years with type 2 diabetes who have a sexual problem, and who are willing to receive information about sexuality and diabetes. Randomization will be at the level of the GP.

Training

Regardless of the general practice’s randomization status, all nurses will be trained on how to perform the recruitment phases of the study, which includes explaining study purposes, handing out the screener questionnaire, processing the results from the screener, approaching eligible patients for further research, and including patients in the study. The PhD student and project leader will train the nurse practitioners.

An experienced GP/sexologist will give the educational training to the GPs in the intervention group. This training focuses on executing the four phases of the PLISSIT model, but also on the GPs capability to recognize and talk about sexual disorders, to improve knowledge and skills with regard to taking a sexual anamnesis, and improving GPs knowledge on when and how a physical examination is relevant to perform.

GPs in the control group will not receive an educational training, instead they will be personally instructed by the PhD student. The PhD student will visit each control group GP and explain that they must hand out a leaflet to their participating patients. The content of the leaflet will be explained and any residual questions will be answered. If the PLISSIT model is found to be effective in our study, we will offer a PLISSIT model training to GPs in the control group after the study has ended.

Recruitment

Eligible patients will be identified and recruited during their routine control visits by the nurse practitioner. The nurse practitioner will use a short screener to identify patients who are unsatisfied about their sexual function and who are willing to talk about their sexual problem with their GP. These patients will subsequently be approached for study participation. 

Intervention

In the intervention group, the nurse practioner will schedule an appointment with the GP for the participating patient. GPs in the intervention group will discuss and treat the patient's sexual problem based on the steps of the PLISSIT model. In the control group, the GP will hand the participating patient an information leaflet regarding Diabetes and Sexuality during the next visit, it is not necessary to schedule an extra appointment. 

Measurements

Participating patients will receive a package of questionnaires at baseline, after three and twelve months. These questionnaires will be filled in by the participating patients anonymously at home.