Abstract
Background
Diabetes, in all forms, imposes an unacceptably high human, social and economic cost on countries at all income levels and it is the fourth most common cause of death globally (1). In Coventry, a medium-sized ethnically diverse UK city, low health literacy and language barriers hamper access to diabetes care for patients living in the deprived inner-city areas, leading to poorer self-management.
Aim
To assess patients and healthcare professionals’ perspectives of a specialist-led Diabetes Risk-based Assessment Clinic (DIRAC) for people with diabetes at high risk of complications (PWDHRC) in deprived areas of Coventry.
Method
A qualitative evaluation of a pilot cluster-randomised trial (QUAN-ECLIPSE) of a specialist team intervention (DIRAC), was undertaken in seven GP practices. Data were collected by observations of weekly face-to-face or virtual patient consultations and monthly interventionists’ meetings; semi-structured interviews were carried out with PWDHRC, primary care clinicians, and interventionists, post-intervention. Thematic analyses of observations and interviews were undertaken.
Results
An ever-changing patient pathway: The PWDHRC pathway is not smooth. However, for all participants, the intervention provided a structure for care and stability.
It’s all about that patient: PWDHRC experienced ‘a good deal' with personalized care from the intervention. Cultural beliefs were addressed and PWDHRC felt empowered to self-manage.
Learning from one another: All participants felt upskilled including PWDHRC, with clinicians acquiring knowledge on how to manage PWDHRC locally. Interventionists felt they were making a difference to PWDHRC.
Future innovative services: The technology utilized alongside specialist clinical input during DIRAC enhanced diabetes management. However, challenges, such as cost and merging databases, require a whole systems approach for widespread implementation.
Conclusion
The specialist-led DIRAC were appreciated by patients and primary care clinicians. The qualitative data support QUAN-ECLIPSE progressing to a full service evaluation
Diabetes, in all forms, imposes an unacceptably high human, social and economic cost on countries at all income levels and it is the fourth most common cause of death globally (1). In Coventry, a medium-sized ethnically diverse UK city, low health literacy and language barriers hamper access to diabetes care for patients living in the deprived inner-city areas, leading to poorer self-management.
Aim
To assess patients and healthcare professionals’ perspectives of a specialist-led Diabetes Risk-based Assessment Clinic (DIRAC) for people with diabetes at high risk of complications (PWDHRC) in deprived areas of Coventry.
Method
A qualitative evaluation of a pilot cluster-randomised trial (QUAN-ECLIPSE) of a specialist team intervention (DIRAC), was undertaken in seven GP practices. Data were collected by observations of weekly face-to-face or virtual patient consultations and monthly interventionists’ meetings; semi-structured interviews were carried out with PWDHRC, primary care clinicians, and interventionists, post-intervention. Thematic analyses of observations and interviews were undertaken.
Results
An ever-changing patient pathway: The PWDHRC pathway is not smooth. However, for all participants, the intervention provided a structure for care and stability.
It’s all about that patient: PWDHRC experienced ‘a good deal' with personalized care from the intervention. Cultural beliefs were addressed and PWDHRC felt empowered to self-manage.
Learning from one another: All participants felt upskilled including PWDHRC, with clinicians acquiring knowledge on how to manage PWDHRC locally. Interventionists felt they were making a difference to PWDHRC.
Future innovative services: The technology utilized alongside specialist clinical input during DIRAC enhanced diabetes management. However, challenges, such as cost and merging databases, require a whole systems approach for widespread implementation.
Conclusion
The specialist-led DIRAC were appreciated by patients and primary care clinicians. The qualitative data support QUAN-ECLIPSE progressing to a full service evaluation
| Original language | English |
|---|---|
| Publication status | Published - 6 Dec 2022 |
| Event | International diabetes federation (IDF) congress Lisbon - Centro de Congressos de Lisboa CCL Praça das Indústrias 1 1300-307 Lisboa Portugal, Lisbon, Portugal Duration: 5 Dec 2022 → 8 Dec 2022 https://idf2022.org/ |
Conference
| Conference | International diabetes federation (IDF) congress Lisbon |
|---|---|
| Abbreviated title | IDF Congress |
| Country/Territory | Portugal |
| City | Lisbon |
| Period | 5/12/22 → 8/12/22 |
| Internet address |
