Process evaluation of team-based care in people aged >65 years with type 2 diabetes mellitus.
Aged
Aged, 80 and over
British Columbia
Community Health Centers
Diabetes Mellitus, Type 2
/ psychology
Diet, Healthy
Exercise
Glycated Hemoglobin
/ analysis
Health Services Accessibility
Humans
Leadership
Learning
Patient Care Team
/ organization & administration
Patient Education as Topic
Primary Health Care
Process Assessment, Health Care
Proof of Concept Study
Single-Blind Method
Social Support
general diabetes
geriatric medicine
qualitative research
team-based care
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
02 08 2019
02 08 2019
Historique:
entrez:
5
8
2019
pubmed:
5
8
2019
medline:
23
9
2020
Statut:
epublish
Résumé
The prevalence of type 2 diabetes mellitus (T2DM) is increasing globally and there is critical need develop interventions to improve health outcomes among older people. The Group Appointments in Primary Care (GAP) study was a randomised controlled trial designed to test the efficacy of a group and team-based medical visit programme to lower haemoglobin A1c among patients with T2DM. We aimed to understand the barriers and facilitators to implement the GAP intervention within a primary care setting, with an emphasis on patient experience. This was a qualitative exploratory study. Data were gathered from semistructured interviews conducted with the first cohort of GAP study participants (n=15) at baseline and intervention completion. GAP participants were aged >65, diagnosed with T2DM and from one primary care clinic. The interview questions identified the patient perspectives and factors relating to their attendance at seven group medical visits that were part of the intervention programme. Data were analysed using framework analysis. We identified four themes that captured participants' experiences: (1) Education: learning with professionals, learning with one another; (2) Social Support: common interests, common problems; (3) Setting: ease of location, ease of conversation and (4) Impact: expectations met, empowerment gained. The GAP intervention increased participants' self-reported diabetes literacy and self-management skills. We learnt that: accessible community centres, not primary care offices, were the ideal location for GAP; the consistent leadership of the primary care physician was valued by participants; and, the content related to exercise and healthy diet were viewed as impactful. Also, learning was achieved through content delivered by clinical experts, and by T2DM experts with lived experience-the GAP peers. Our findings highlight the important role of group learning. NCT02002143.
Identifiants
pubmed: 31377711
pii: bmjopen-2019-029965
doi: 10.1136/bmjopen-2019-029965
pmc: PMC6687023
doi:
Substances chimiques
Glycated Hemoglobin A
0
Banques de données
ClinicalTrials.gov
['NCT02002143']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e029965Subventions
Organisme : CIHR
Pays : Canada
Informations de copyright
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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