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Provision of services in primary care for type 2 diabetes: a qualitative study with patients, GPs and nurses

Provision of services in primary care for type 2 diabetes: a qualitative study with patients, GPs and nurses
Provision of services in primary care for type 2 diabetes: a qualitative study with patients, GPs and nurses
Background: there is little evidence on the impact of national pressures on primary care provision for type 2 diabetes from the perspectives of patients and their GPs and nurses.

Aim: to explore experiences of primary care provision for people with type 2 diabetes and their respective GPs and nurses.

Design and setting: a qualitative interview study in the East of England

Methods: semi-structured interviews with people who have type 2 diabetes (n=24) along with their respective GPs and nurses (n=15). Purposive sampling was used to select for heterogeneity in glycaemic control and previous healthcare experiences. Interviews were audio-recorded and analysed thematically. The consolidated criteria for reporting qualitative research were followed.

Results: we identified a changing landscape of diabetes provision owing to burgeoning pressures that were presented repeatedly. Patient participants wanted GP-delivered care with continuity. They saw GPs as experts best placed to support them in managing diabetes, but were increasingly receiving nurse-led care. Nurses reported providing most of the in-person care, while GPs remained accountable but increasingly distanced from face-to-face diabetes provision. A reluctant acknowledgement surfaced amongst GPs, nurses and their patients that only minimum care standards could be maintained, with aspirations for high quality provision unlikely to be met.

Conclusion: Type 2 diabetes is a tracer condition that reflects many aspects of primary care. Efforts to manage pressures have not been perceived favourably, despite some benefits. Reframing expectations of care, by communicating solutions to both patients and providers so that they are understood, managed and realistic, may be one way forward
0960-1643
Dambha-Miller, Hajira
58961db5-31aa-460e-9394-08590c4b7ba1
Griffin, Simon J.
4dc49a63-d07a-4d7f-b159-478126c0edff
Kinmonth, Ann Louise
eede622c-cfbd-492f-8268-dc77ce097b29
Burt, Jenni
cc945655-bef5-4135-8fd7-4dd98ce99ea0
Dambha-Miller, Hajira
58961db5-31aa-460e-9394-08590c4b7ba1
Griffin, Simon J.
4dc49a63-d07a-4d7f-b159-478126c0edff
Kinmonth, Ann Louise
eede622c-cfbd-492f-8268-dc77ce097b29
Burt, Jenni
cc945655-bef5-4135-8fd7-4dd98ce99ea0

Dambha-Miller, Hajira, Griffin, Simon J., Kinmonth, Ann Louise and Burt, Jenni (2020) Provision of services in primary care for type 2 diabetes: a qualitative study with patients, GPs and nurses. British Journal of General Practice. (In Press)

Record type: Article

Abstract

Background: there is little evidence on the impact of national pressures on primary care provision for type 2 diabetes from the perspectives of patients and their GPs and nurses.

Aim: to explore experiences of primary care provision for people with type 2 diabetes and their respective GPs and nurses.

Design and setting: a qualitative interview study in the East of England

Methods: semi-structured interviews with people who have type 2 diabetes (n=24) along with their respective GPs and nurses (n=15). Purposive sampling was used to select for heterogeneity in glycaemic control and previous healthcare experiences. Interviews were audio-recorded and analysed thematically. The consolidated criteria for reporting qualitative research were followed.

Results: we identified a changing landscape of diabetes provision owing to burgeoning pressures that were presented repeatedly. Patient participants wanted GP-delivered care with continuity. They saw GPs as experts best placed to support them in managing diabetes, but were increasingly receiving nurse-led care. Nurses reported providing most of the in-person care, while GPs remained accountable but increasingly distanced from face-to-face diabetes provision. A reluctant acknowledgement surfaced amongst GPs, nurses and their patients that only minimum care standards could be maintained, with aspirations for high quality provision unlikely to be met.

Conclusion: Type 2 diabetes is a tracer condition that reflects many aspects of primary care. Efforts to manage pressures have not been perceived favourably, despite some benefits. Reframing expectations of care, by communicating solutions to both patients and providers so that they are understood, managed and realistic, may be one way forward

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More information

Accepted/In Press date: 26 February 2020

Identifiers

Local EPrints ID: 440677
URI: http://eprints.soton.ac.uk/id/eprint/440677
ISSN: 0960-1643
PURE UUID: a7e69f9f-09f4-4e7f-9d8a-d504d6d31f98
ORCID for Hajira Dambha-Miller: ORCID iD orcid.org/0000-0003-0175-443X

Catalogue record

Date deposited: 13 May 2020 16:34
Last modified: 13 Dec 2021 03:31

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Contributors

Author: Simon J. Griffin
Author: Ann Louise Kinmonth
Author: Jenni Burt

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