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Randomized Controlled Trial
. 2007 Sep 8;335(7618):490.
doi: 10.1136/bmj.39308.392176.BE. Epub 2007 Aug 30.

Patients' experiences of screening for type 2 diabetes: prospective qualitative study embedded in the ADDITION (Cambridge) randomised controlled trial

Helen Eborall  1 , Richard Davies, Ann-Louise Kinmonth, Simon Griffin, Julia Lawton
Affiliations
Randomized Controlled Trial

Patients' experiences of screening for type 2 diabetes: prospective qualitative study embedded in the ADDITION (Cambridge) randomised controlled trial

Helen Eborall et al. BMJ. .

Abstract

Objectives: To provide insight into factors that contribute to the anxiety reported in a quantitative study of the psychological effect of screening for type 2 diabetes. To explore expectations of and reactions to the screening experience of patients with positive, negative, and intermediate results.

Design: Prospective qualitative interview study of patients attending a screening programme for type 2 diabetes.

Setting: Seven general practices in the ADDITION (Cambridge) trial in the east of England.

Participants: 23 participants (aged 50-69) attending different stages in the screening process.

Results: Participants' perceptions changed as they progressed through the screening programme; the stepwise process seemed to help them adjust psychologically. The first screening test was typically considered unimportant and was attended with no thought about its implications. By the final diagnostic test, type 2 diabetes was considered a strong possibility, albeit a "mild" form. After diagnosis, people with screen detected type 2 diabetes tended to downplay its importance and talked confidently about their plans to control it. Participants with intermediate results seemed uncertain about their diagnosis, and those who screened negative were largely unaware of their remaining high risk.

Conclusions: This study helps in understanding the limited psychological impact of screening for type 2 diabetes quantified previously, in particular by the quantitative substudy of ADDITION (Cambridge). The findings have implications for implementing such a screening programme in terms of timing and content.

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Conflict of interest statement

Competing interests: None declared.

Comment in

  • Screening for diabetes.
    Stolk RP. Stolk RP. BMJ. 2007 Sep 8;335(7618):457-8. doi: 10.1136/bmj.39323.395336.BE. Epub 2007 Aug 30. BMJ. 2007. PMID: 17761997 Free PMC article.

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