Process evaluation of team-based care in people aged >65 years with type 2 diabetes mellitus
Objective 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 g...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2019-08-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/9/8/e029965.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850267413062352896 |
|---|---|
| author | Joanie Sims Gould Catherine Tong Jessica Ly Sara Vazirian Adriaan Windt Karim Khan |
| author_facet | Joanie Sims Gould Catherine Tong Jessica Ly Sara Vazirian Adriaan Windt Karim Khan |
| author_sort | Joanie Sims Gould |
| collection | DOAJ |
| description | Objective 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.Research design and methods 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.Results 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.Conclusions 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.Trial registration number NCT02002143 |
| format | Article |
| id | doaj-art-a6f664ce250c4095885fef1bd644a429 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-08-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-a6f664ce250c4095885fef1bd644a4292025-08-20T01:53:48ZengBMJ Publishing GroupBMJ Open2044-60552019-08-019810.1136/bmjopen-2019-029965Process evaluation of team-based care in people aged >65 years with type 2 diabetes mellitusJoanie Sims Gould0Catherine Tong1Jessica Ly2Sara Vazirian3Adriaan Windt4Karim Khan5University of British Columbia, Vancouver, British Columbia, Canada1 Centre for Hip Health and Mobility, University of British Columbia, Vancouver, British Columbia, Canada1 Centre for Hip Health and Mobility, University of British Columbia, Vancouver, British Columbia, Canada1 Centre for Hip Health and Mobility, University of British Columbia, Vancouver, British Columbia, Canada1 Centre for Hip Health and Mobility, University of British Columbia, Vancouver, British Columbia, Canada1 School of Kinesiology, University of British Columbia, Vancouver, British Columbia, CanadaObjective 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.Research design and methods 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.Results 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.Conclusions 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.Trial registration number NCT02002143https://bmjopen.bmj.com/content/9/8/e029965.full |
| spellingShingle | Joanie Sims Gould Catherine Tong Jessica Ly Sara Vazirian Adriaan Windt Karim Khan Process evaluation of team-based care in people aged >65 years with type 2 diabetes mellitus BMJ Open |
| title | Process evaluation of team-based care in people aged >65 years with type 2 diabetes mellitus |
| title_full | Process evaluation of team-based care in people aged >65 years with type 2 diabetes mellitus |
| title_fullStr | Process evaluation of team-based care in people aged >65 years with type 2 diabetes mellitus |
| title_full_unstemmed | Process evaluation of team-based care in people aged >65 years with type 2 diabetes mellitus |
| title_short | Process evaluation of team-based care in people aged >65 years with type 2 diabetes mellitus |
| title_sort | process evaluation of team based care in people aged 65 years with type 2 diabetes mellitus |
| url | https://bmjopen.bmj.com/content/9/8/e029965.full |
| work_keys_str_mv | AT joaniesimsgould processevaluationofteambasedcareinpeopleaged65yearswithtype2diabetesmellitus AT catherinetong processevaluationofteambasedcareinpeopleaged65yearswithtype2diabetesmellitus AT jessicaly processevaluationofteambasedcareinpeopleaged65yearswithtype2diabetesmellitus AT saravazirian processevaluationofteambasedcareinpeopleaged65yearswithtype2diabetesmellitus AT adriaanwindt processevaluationofteambasedcareinpeopleaged65yearswithtype2diabetesmellitus AT karimkhan processevaluationofteambasedcareinpeopleaged65yearswithtype2diabetesmellitus |