Same goals, different challenges: A systematic review of perspectives of people with diabetes and healthcare professionals on Type 2 diabetes care

Abstract

Aims To identify the views of people with Type 2 diabetes (PWD) and healthcare professionals (HCP) about diabetes care. Methods A systematic review of qualitative studies reporting both groups’ views using thematic synthesis frameworked by the eHealth Enhanced Chronic Care Model was conducted. Results We searched six electronic databases between 2010 and 2020, identified 6999 studies and included 21. Thirty themes were identified with in general complementary views between PWD and HCP. PWD and HCP find lifestyle changes challenging and get frustrated when PWD struggle to achieve it. Good self‐management requires a trustful PWD–HCP relationship. Diabetes causes distress and often HCP focus on clinical aspects. They value diabetes education. PWD require broader, tailored, consistent and ongoing information, but HCPs do not have enough time for providing it. There is need for diabetes training for primary HCP. Shared decision making can mitigate PWD’s fears. Different sources of social support can influence PWD’s ability to self‐manage and PWD/HCP suggest online peer groups. PWD/HCP indicate lack of communication and collaboration between HCP. PWD’s and HCP’s views about quality in diabetes care differ. They believe that comprehensive, multidisciplinary and locally provided care can help to achieve better outcomes. They recognise digital health benefits, with room for personal interaction (PWD) and eHealth literacy improvements (HCP). Evidence‐based guidelines are important but can detract from personalised care. Conclusion We hypothesise that including PWD’s and HCP’s complementary views, multidisciplinary teams and digital tools in the redesign of Type 2 diabetes care can help with overcoming some of the challenges and achieving common goals.

A qualitative analysis of the needs and wishes of people with type 2 diabetes and healthcare professionals for optimal diabetes care

“…Similarly to these findings, a systematic review conducted by our team concluded that generally both groups have similar views about components of diabetes care, but HCPs struggle to meet PWD's holistic needs. 17 This demonstrates that there is an alignment of the perceived needs for improved diabetes care among main stakeholders, however, important gaps still remain. Other studies have identified gaps between what stakeholders wish for and what healthcare systems deliver.…”

“…All steps were guided by key stakeholders' contributions, and information uncovered at each step influenced the next until a solution was designed and endorsed by all. Step 1 included a literature review, published separately as a systematic review, 17 and review of grey literature. This article reports the subsequent part of step 1—focus groups and interviews with stakeholders.…”

“…We first identified reported needs of PWD and HCPs through a literature review, 17 which supported the preparation of the semi-structured focus group and interview guide (Appendix A). Two researchers (DB and MJ) trained in qualitative research conducted and audio-recorded the interviews and focus groups between November 2019 and January 2020.…”

Exploring facilitators and barriers to self-management engagement of Chinese people with type 2 diabetes mellitus and poor blood glucose control: A descriptive qualitative study

“…Providing patients with knowledge about diabetes and self-care behaviors could increase awareness of the necessity of self-management, which motivated self-management engagement in route life [19][20][21][22][23][24][25][26][27][28][29]. However, people with diabetes could be reluctant to obtain new knowledge about diabetes and to use the knowledge to manage diabetes in routine life [20,[25][26].…”

“…However, people with diabetes could be reluctant to obtain new knowledge about diabetes and to use the knowledge to manage diabetes in routine life [20,[25][26]. This might be caused by that the knowledge was inconsistent with personal demands and was not culturally sensitive [19][20][21][22][23][24][25][26][28][29] Social support could increase self-management engagement [19][20][21][22][23][24][25][27][28][29]. However, the in uences of social support on diabetes self-management engagement were various across populations of different continents [19][20][21][22][23][24][27][28][29].…”