Patients' and healthcare providers' perspectives on diabetes management: A systematic review of qualitative studies

Abstract

Background: Despite the availability of evidence-based guidance to deliver effective diabetes care, many patients do not achieve goals as recommendations. This systematic review was to synthesize useful insight perspectives by patients and providers to identify factors related to diabetes management using Chronic Care Model.

Objective: This systematic review aimed to synthesize perspectives by patients and providers in order to identify factors related to diabetes management.

Methods: Databases were searched including CINAHL, PubMed, Science Direct, and Web of Science from January 2001 to September 2017. Combination of search terms were used like 'qualitative,' 'diabetes management,' 'patients' perspective,' and 'provider's perspective.' All qualitative studies used were in English with available full text. Chronic Care Model framework was used to analyze the content and to organize the findings.

Results: Of 108 articles used, only 23 of this met the inclusion criteria. Nine factors were identified including community linkage, health service system for diabetic patients, continuity of care, self-management, providers' support, referral system, patient-provider interaction, increasing competency of healthcare providers and family support. Community linkage was revealed to be an important factor to encourage diabetic patients to look after their disease while health service system showed the limit of accessibility due to location, medical service availability, finance, information, and time. Continuity of care has shown lack of coordination in referral system within a health care team and self-management was dependent on the knowledge, beliefs, attitude, and behavior of the patient. More so, providers' support through an effective plan and/or strategy has also indicated to help patients get their target goal. Poor interaction between patients and health providers was found to be largely attributed to language barrier and lack of communication skill. Improving competency for the health providers can be achieved through continuing professional education. Both perspectives supported a family involvement and community resources for diabetes patients.

Conclusion: Factors related to diabetes management from nine themes showed various gaps in both perspectives. Further research on new models for diabetes management is required.

Keywords: Diabetes management; Patients' perspectives; Providers' perspectives; Qualitative; Systematic review.