Interprofessional care of patients with type 2 diabetes mellitus in primary care: family physicians’ perspectives

Abstract

Background There is a lack of understanding of the team processes and factors that influence teamwork and medication management practices in the care of patients with type 2 diabetes mellitus (T2DM). The purpose of the study was to explore physicians’ perspectives of barriers and facilitators to interprofessional care of patients with T2DM within team-based family practice settings. Methods This was a qualitative, descriptive study. Participants included physicians affiliated with a primary care network providing care to patients with T2DM in an interprofessional team-based primary care setting in Edmonton, Alberta, Canada. Participants’ contact information was obtained from the publicly available College of Physicians and Surgeons of Alberta and respective primary care network websites. Interview questions addressed physicians’ perspectives on factors or processes that facilitated and hindered the care and medication management of adult patients with T2DM in primary care team-based clinical practice. Interviews were audio-recorded, transcribed, and analyzed using qualitative content analysis and a constant comparative approach. Results A total of 15 family physicians participated in individual interviews. Family physicians identified facilitators of interprofessional team-based care and medication management of patients with T2DM in three theme areas—access to team members and programs, knowledgeable and skilled health professionals, and provision of patient education by other health professionals. Two themes emerged as barriers to interprofessional care – lack of provider continuity and the loss of skills from delegation of tasks. Conclusion Family physicians perceive both benefits and risks to interprofessional team-based care in caring for patients with T2DM. Successful functioning of team-based care in family practice will require overcoming traditional professional roles.

Trends in the primary healthcare nursing workforce in managing diabetes from two sample surveys in 2006–2008 and 2016 in Auckland, New Zealand

“…28 These trends indicate increasing capacity and autonomy in managing patients with chronic conditions and are consistent with global trends, 2 although the increased support only extended to conducting DAR, not general diabetes management, and may reflect resistance to changing traditional models of primary care identified in a Canadian survey. 29 The proportion of nurses who provided nutritional and physical activity education remained the same over time, despite a significant increase in patients' mean BMIs, 17 reflecting the many challenges and barriers engaging patients about lifestyle changes in an obesogenic environment.…”