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Digital health interventions for adults with type 2 diabetes: Qualitative study of patient perspectives on diabetes self-management education and support

Digital health interventions for adults with type 2 diabetes: Qualitative study of patient perspectives on diabetes self-management education and support
Digital health interventions for adults with type 2 diabetes: Qualitative study of patient perspectives on diabetes self-management education and support

Background: The prevalence of type 2 diabetes is increasing globally, and health services in many countries are struggling with the morbidity, mortality, and costs associated with the complications of this long-term condition. Diabetes self-management education (DSME) and behavioral support can reduce the risks of developing diabetes-related complications and improve glycemic control. However, their uptake is low. Digital health interventions (DHI) can provide sustained support and may overcome challenges associated with attending diabetes self-management sessions. They have the potential for delivery at multiple locations at convenient times, anonymity, and presentation of content in attractive and tailored formats. This study investigates the needs and wants of patients with type 2 diabetes to inform the development of digital self-management education and support. Objective: The objective of this study was to explore patient perspectives on unmet needs for self-management and support and the role of DHI in adults living with type 2 diabetes. Methods: This study used a qualitative approach based on data generated from 4 focus groups with 20 patients. Results: The data generated by the focus groups illustrated the significant burden that the diagnosis of diabetes places on many patients and the negative impacts on their emotional well-being, work, social life, and physical health. Although patients' experiences of the health care services varied, there was agreement that even the best services were unable to meet all users' needs to support the emotional regulation, psychological adjustment, and behavioral changes needed for successful self-management. Conclusions: By focusing on medical management and information provision, existing health care services and education programs may not be adequately meeting all the needs of patients with type 2 diabetes. DHIs have the potential to improve access to DSME and behavioral support and extend the range of content offered by health services to fit with a wider range of patient needs. Features that could help DHIs address some of the unmet needs described by participants in this study included placing an emphasis on emotional and role management, being available at all times, having up-to-date evidence-based guidance for patients, and providing access to peer-generated and professional advice.

Diabetes mellitus, EHealth, MHealth, Patient education, Qualitative research, Self-management, Type 2
1438-8871
Pal, Kingshuk
7b68a984-eb75-4727-865a-7d27a64a806e
Dack, Charlotte
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Ross, Jamie
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Michie, Susan
47e0a907-79cb-47d5-b5a9-82d2afe1747a
May, Carl
17697f8d-98f6-40d3-9cc0-022f04009ae4
Stevenson, Fiona
881eb2a9-d7a8-449d-be50-ead6fda5cd3e
Farmer, Andrew
c384123c-1276-4d06-a2b5-d5419bd83b1d
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Barnard, Maria
0fb01491-b1da-481b-84a5-36e20f525743
Murray, Elizabeth
cb300780-9041-44af-9ae5-e13531eb23b8
Pal, Kingshuk
7b68a984-eb75-4727-865a-7d27a64a806e
Dack, Charlotte
d3b4f40f-0c5d-4117-9aaa-e500976d4af5
Ross, Jamie
55b300ae-4a06-418d-b0b7-fdbab91e9970
Michie, Susan
47e0a907-79cb-47d5-b5a9-82d2afe1747a
May, Carl
17697f8d-98f6-40d3-9cc0-022f04009ae4
Stevenson, Fiona
881eb2a9-d7a8-449d-be50-ead6fda5cd3e
Farmer, Andrew
c384123c-1276-4d06-a2b5-d5419bd83b1d
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Barnard, Maria
0fb01491-b1da-481b-84a5-36e20f525743
Murray, Elizabeth
cb300780-9041-44af-9ae5-e13531eb23b8

Pal, Kingshuk, Dack, Charlotte, Ross, Jamie, Michie, Susan, May, Carl, Stevenson, Fiona, Farmer, Andrew, Yardley, Lucy, Barnard, Maria and Murray, Elizabeth (2018) Digital health interventions for adults with type 2 diabetes: Qualitative study of patient perspectives on diabetes self-management education and support. Journal of Medical Internet Research, 20 (2), [e40]. (doi:10.2196/jmir.8439).

Record type: Article

Abstract

Background: The prevalence of type 2 diabetes is increasing globally, and health services in many countries are struggling with the morbidity, mortality, and costs associated with the complications of this long-term condition. Diabetes self-management education (DSME) and behavioral support can reduce the risks of developing diabetes-related complications and improve glycemic control. However, their uptake is low. Digital health interventions (DHI) can provide sustained support and may overcome challenges associated with attending diabetes self-management sessions. They have the potential for delivery at multiple locations at convenient times, anonymity, and presentation of content in attractive and tailored formats. This study investigates the needs and wants of patients with type 2 diabetes to inform the development of digital self-management education and support. Objective: The objective of this study was to explore patient perspectives on unmet needs for self-management and support and the role of DHI in adults living with type 2 diabetes. Methods: This study used a qualitative approach based on data generated from 4 focus groups with 20 patients. Results: The data generated by the focus groups illustrated the significant burden that the diagnosis of diabetes places on many patients and the negative impacts on their emotional well-being, work, social life, and physical health. Although patients' experiences of the health care services varied, there was agreement that even the best services were unable to meet all users' needs to support the emotional regulation, psychological adjustment, and behavioral changes needed for successful self-management. Conclusions: By focusing on medical management and information provision, existing health care services and education programs may not be adequately meeting all the needs of patients with type 2 diabetes. DHIs have the potential to improve access to DSME and behavioral support and extend the range of content offered by health services to fit with a wider range of patient needs. Features that could help DHIs address some of the unmet needs described by participants in this study included placing an emphasis on emotional and role management, being available at all times, having up-to-date evidence-based guidance for patients, and providing access to peer-generated and professional advice.

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Accepted/In Press date: 30 October 2017
e-pub ahead of print date: 29 January 2018
Published date: 1 February 2018
Keywords: Diabetes mellitus, EHealth, MHealth, Patient education, Qualitative research, Self-management, Type 2

Identifiers

Local EPrints ID: 418951
URI: http://eprints.soton.ac.uk/id/eprint/418951
ISSN: 1438-8871
PURE UUID: ae32c37d-7715-4406-9a5b-d2ed641fd0c4
ORCID for Carl May: ORCID iD orcid.org/0000-0002-0451-2690
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X

Catalogue record

Date deposited: 27 Mar 2018 16:30
Last modified: 16 Mar 2024 03:03

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Contributors

Author: Kingshuk Pal
Author: Charlotte Dack
Author: Jamie Ross
Author: Susan Michie
Author: Carl May ORCID iD
Author: Fiona Stevenson
Author: Andrew Farmer
Author: Lucy Yardley ORCID iD
Author: Maria Barnard
Author: Elizabeth Murray

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