Healthcare professionals, patients agree on a pathway to improve care for type 2 diabetes

New results suggest a reconciliation of perceived needs and wants for improved type 2 diabetes care in people with diabetes and health care professionals, although important health care gaps still exist.

“Globally, type 2 diabetes care is often fragmented and still organized in a provider-centric manner, resulting in sub-optimal care for many individuals,” Anthony Russell, MBBS, PhD, FRACP, director of endocrinology at Princess Alexandra Hospital and honorary associate professor at the Center for Health Services Research at the University of Queensland in Brisbane, Australia, and colleagues wrote. “As healthcare systems seek to implement digital healthcare innovations, it is time to reassess stakeholder priorities to guide the redesign of diabetes care.”

The researchers wanted to map the needs and desires of adults with type 2 diabetes and teams of specialists and primary care for optimal diabetes care to determine how to better support patients with diabetes in a metropolitan health care system in Australia.

Guided by a participatory design approach, where stakeholders are actively involved in the design process, the researchers conducted four focus groups and 16 interviews from November 2019 to January 2020. In total there were 17 adults with type 2 diabetes, seven specialist clinicians with diabetes outpatient clinic in Brisbane, Australia, and seven primary care professionals from various clinics in Brisbane.

According to the research methodology, the researchers assessed data with reflexive thematic analysis, building on the Capacity, Opportunity, Motivation, and Behavior (COM-B) model. This model describes behaviors that arise from interactions between knowledge and skills (ability); social and physical environment (chance); and emotions and plans (motivation).

Data showed that adults with diabetes expressed a desire to be holistically equipped, supported and recognized for their efforts, as well as to receive personalized care at the right time and improved access to connected services; healthcare professionals agreed, expressing their own burden as a result of the challenging work.

“Overall, both groups wanted holistic, personalized, supportive, proactive and coordinated care pathways,” Silva and colleagues wrote.

They added that this study is the first step of a participatory design project to explore stakeholder needs for optimal type 2 diabetes care, with a separate publication of the next steps, including proposed solutions and redesigned care pathways.

“We conclude that there is a reconciliation of perceived needs for improved diabetes care in adults with type 2 diabetes and health care professionals,” the researchers wrote. “Overall, both groups wanted holistic, personalized, supportive, proactive and coordinated care pathways. New care pathways need to take into account stakeholder views to close the gap between their needs and current health care.”