Patients' and healthcare providers’ perspectives on diabetes management: A systematic review of qualitative studies

Sibounheuang, Phoutsathaphone; Olson, Phayom Sookaneknun; Kittiboonyakun, Pattarin

doi:10.1016/j.sapharm.2019.09.001

Cited by 30 publications

(53 citation statements)

References 72 publications

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“…In the present review, a wide variety of challenges regarding diabetes management were identified, in which many of them were similar to challenges identified in other studies around the world [29][30][31]. However, some cultural/context specific barriers in diabetes management were identified such as counter to self-care expectations of relatives (e.g.…”

Section: Discussionsupporting

confidence: 64%

Challenges of managing diabetes in Iran: meta-synthesis of qualitative studies

Mohseni

Ghoreishi

Houshmandi

et al. 2020

BMC Health Serv Res

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Background: Although several diabetes management and control programmes are introduced in Iran, many patients do not achieve diabetes-related clinical goals as recommended. The aim of this study was to identify the qualitative evidence for the challenges regarding diabetes management. Methods: A systematic review of qualitative studies following PRISMA guidelines was undertaken. Scopus, PubMed, Science Direct, and Web of Knowledge were searched as well as Persian databases including Magiran, Irandoc and SID from inception to August 2019. The included Studies were either in English-or Persian-language qualitative studies reporting the perspectives of patients, their relatives, or healthcare service providers. Content of the findings were analysed and organized according to Chronic Care Model framework. Results: Twelve studies met the inclusion criteria. Six main themes were identified including holistic understanding of patients, leadership and governance difficulties, service delivery, workforce, financing, and information and research. Conclusion: Challenges regarding the management of diabetes in Iran is multifaceted. Reforming the health care system or developing complementary strategies is essential to improve suitable health care model for patients with chronic conditions such as diabetic patients.

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Section: Discussionsupporting

confidence: 64%

Challenges of managing diabetes in Iran: meta-synthesis of qualitative studies

Mohseni

Ghoreishi

Houshmandi

et al. 2020

BMC Health Serv Res

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“…Patients with COPD described family and friends as the main support for treatment workload [41]. However, the obstructive behaviours of some families were barriers to SM [96,123,124,130,141]. Social relationships influenced the perceptions of patients with obesity [142].…”

Section: 211mentioning

confidence: 99%

“…Healthcare professionals considered limited resources, heavy workloads, or environmental constraints to be barriers to implementing SM [93,143]. Of these, consultation time was the most frequently reported by both patients and healthcare professionals [41,89,96,99,123,128,130]. In T2DM, some healthcare professionals reported not being able to directly address patients' broader psychosocial SM because of a lack of experience or training in effective communication, counselling, goal setting, and shared decision making [57,99].…”

Section: 211mentioning

confidence: 99%

“…Access to Healthcare Factors that restricted timely access to healthcare services were reported across the four chronic diseases and included the associated cost of treatment, lack of health insurance, lack of community-based resources, distance, weather, transportation, and structural or cultural barriers [43,72,94,121,123,130,153,154]. Access to a specialist, nursing care, SM programmes, and alternative therapy was an essential factor for SM [54,98,110].…”

Section: Factors That Influenced Self-managementmentioning

confidence: 99%

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The Perspectives of Patients with Chronic Diseases and Their Caregivers on Self-Management Interventions: A Scoping Review of Reviews

Guzmán

García

Orrego

et al. 2021

Patient

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Background Self-management (SM) interventions are supportive interventions systematically provided by healthcare professionals, peers, or laypersons to increase the skills and confidence of patients in their ability to manage chronic diseases. We had two objectives: (1) to summarise the preferences and experiences of patients and their caregivers (informal caregivers and healthcare professionals) with SM in four chronic diseases and (2) to identify and describe the relevant outcomes for SM interventions from these perspectives. Methods We conducted a mixed-methods scoping review of reviews. We searched three databases until December 2020 for quantitative, qualitative, or mixed-methods reviews exploring patients' and caregivers' preferences or experiences with SM in type 2 diabetes mellitus (T2DM), obesity, chronic obstructive pulmonary disease (COPD), and heart failure (HF). Quantitative data were narratively synthesised, and qualitative data followed a three-step descriptive thematic synthesis. Identified themes were categorised into outcomes or modifiable factors of SM interventions. Results We included 148 reviews covering T2DM (n = 53 [35.8%]), obesity (n = 20 [13.5%]), COPD (n = 32 [21.6%]), HF (n = 38 [25.7%]), and those with more than one disease (n = 5 [3.4%]). We identified 12 main themes. Eight described the process of SM (disease progression, SM behaviours, social support, interaction with healthcare professionals, access to healthcare, costs for patients, culturally defined roles and perceptions, and health knowledge), and four described their experiences with SM interventions (the perceived benefit of the intervention, individualised care, sense of community with peers, and usability of equipment). Most themes and subthemes were categorised as outcomes of SM interventions. Conclusion The process of SM shaped the perspectives of patients and their caregivers on SM interventions. Their perspectives were influenced by the perceived benefit of the intervention, the sense of community with peers, the intervention's usability, and the level of individualised care. Our findings can inform the selection of patient-important outcomes, decisionmaking processes, including the formulation of recommendations, and the design and implementation of SM interventions.

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“…In these countries, and many others, T2DM represents about 90% of all diabetes cases 1‐3 . Though it is well known that adequate glycaemic control can reduce the risks for complications and premature death in people with diabetes, many patients struggle to follow recommendations for treatment 4 . Consequently, they remain at risk for diabetic complications.…”

Section: Introductionmentioning

confidence: 99%

Diabetes care provided by national standards can improve patients' self‐management skills: A qualitative study of how people with type 2 diabetes perceive primary diabetes care

Husdal

Adolfsson

Leksell

et al. 2021

Health Expectations

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Background The increasing incidence of type 2 diabetes mellitus [T2DM] has resulted in extensive research into the characteristics of successful primary diabetes care. Even if self‐management support and continuity are increasingly recognized as important, there is still a need for deeper understanding of how patients' experiences of continuity of care coincide with their needs for self‐management and/or self‐management support. Objective To gain a deeper understanding of how people with T2DM perceive Swedish primary diabetes care and self‐management support. Methods This qualitative study used focus groups as the means for data collection. Participants were identified through a purposive sampling method differing in age, sex, diabetes duration and latest registered glycated haemoglobin level. Twenty‐eight participants formed five focus groups. Qualitative content analysis was applied to interview transcripts. Results The main theme emerging from the focus group data was that diabetes care provided by national standards improved self‐management skills. Two themes that emerged from the analysis were (a) the importance of a clarification of structures and procedures in primary diabetes care and (b) health‐care staff ‘being there’ and providing support enables trust and co‐operation to enhance self‐management. Conclusions Individual patients' self‐management resources are strengthened if the importance of providing relational continuity, management continuity and informational continuity is considered. Patients also need assistance on ‘how’ self‐management activities should be performed. Patient contribution Prior to the study, one pilot focus group was conducted with patients to obtain their perspectives on the content of the planned focus groups; thus, patients were involved in both planning and conduct of the study.

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Patients' and healthcare providers’ perspectives on diabetes management: A systematic review of qualitative studies

Cited by 30 publications

References 72 publications

Challenges of managing diabetes in Iran: meta-synthesis of qualitative studies

Challenges of managing diabetes in Iran: meta-synthesis of qualitative studies

The Perspectives of Patients with Chronic Diseases and Their Caregivers on Self-Management Interventions: A Scoping Review of Reviews

Diabetes care provided by national standards can improve patients' self‐management skills: A qualitative study of how people with type 2 diabetes perceive primary diabetes care

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