Table 6.

Analysis of open-ended text evaluations by the health care professional after each visit.

Main themes		Quote or case example
Benefits of use of PROa in the visit
	The person with diabetes was better prepared due to self-reflection in advance	“I tend to ask a lot of questions if the patient does not say so much. In this case the patient had already reflected and prioritized which allowed us to focus on this instead of ‘shooting in the blind’.”
	Better able to set agenda in line with patient priorities	“I distributed the available time better, focused on the problems of the patient, listened more”
	New insights about which topics are important to the person with diabetes.	New topics identified as important to the person with diabetes included worry about complications, foot wound, erectile dysfunction, sleep, pain, and barriers in life situation to managing diabetes.
Challenges regarding use of PRO in the visit
	Managing the conversation when there are many flagged PRO topics	“Dialogue would have been better if we had had more time to wrap up the various problem areas identified” “There were so many answers to consider that it extended the visit.”
Not all PRO outputs were relevant to act on
	Red score on pain	A person with diabetes scored red on pain, but it was because of arthritis pain that was already treated and addressed in other care setting.
	Red score on low well-being	A person with diabetes scored red on low well-being, but it was because of life issues unrelated to diabetes.
	Uncertainties regarding use	Unsure how to handle a discrepancy between a PRO score and what the person with diabetes says in the visit.

^aPRO: patient-reported outcome.