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BMC Health Services Research

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Open Access 01-12-2019 | Care | Research article

Patients’ perspective on self-management: type 2 diabetes in daily life

Authors: Astrid N. van Smoorenburg, Dorijn F. L. Hertroijs, Tessa Dekkers, Arianne M. J. Elissen, Marijke Melles

Published in: BMC Health Services Research | Issue 1/2019

Abstract

Background

The number of type 2 diabetes mellitus (T2DM) patients and related treatment costs are rapidly increasing. Consequentially, more cost-effective and efficient strategies for the treatment of T2DM are needed. One such strategy is improving patients’ self-management. As patients are more and more expected to self-manage their disease, it is important to provide them with suitable self-management support. This way, success of self-management will increase and complications and related costs of T2DM can be reduced. Currently, self-management support is developed mainly from the perspective of health professionals and caregivers, rather than patients. This research focused on gaining a better understanding of patients’ perspectives on self-management and support.

Methods

Semi-structured interviews, preceded by preparatory assignments, were conducted with ten patients with T2DM treated in Dutch primary care.

Results

We found that patients experience ‘active’ self-management when recently diagnosed. As time progresses and no problems occur, patients do not experience their disease-related behaviour as self-management. Diabetes has ‘just’ become part of their daily life, now including new routines taking diabetes into account.

Conclusions

With this knowledge, support solutions can be designed and implemented that better fit the needs, preferences and abilities of patients with T2DM.

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International Diabetes Federation. IDF Diabetes Atlas, 7 ed. Brussels, Belgium: International Diabetes Federation; 2015.

Cebolla Garrofé B, Björnberg A, Yung Phang A. Euro Diabetes Index 2014. Täby: Health Consumer Powerhouse Ltd; 2014.

InEen. Transparent integrated care. Report 2015 care groups. Diabetes mellitus, VRM, COPD and asthma [Transparante ketenzorg. Rapportage 2015 zorggroepen. Diabetes mellitus, VRM, COPD en astma. Op weg naar genuanceerde rapportage van zorg]. Utrecht: InEen; 2016.

Wermeling PR, Gorter KJ, Stellato RK, de Wit GA, Beulens JW, Rutten GE. Effectiveness and cost-effectiveness of 3-monthly versus 6-monthly monitoring of well-controlled type 2 diabetes patients: a pragmatic randomised controlled patient-preference equivalence trial in primary care (EFFIMODI study). Diabetes Obes Metab. 2014;16:841–9. https://doi.org/10.1111/dom.12288.CrossRefPubMed

Chatterjee S, Khunti K, Davies MJ. Type 2 diabetes. Lancet. 2017;389(10085):2239–51. https://doi.org/10.1016/S0140-6736(17)30058-2.CrossRefPubMed

Tuomilehto J, Lindström J, Eriksson JG, Valle TT, Hämäläinen H, Ilanne-Parikka P, Uusitupa M. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001;344(18):1343–50. https://doi.org/10.1056/NEJM200105033441801.CrossRefPubMed

Hu FB, Manson JE, Stampfer MJ, Colditz G, Liu S, Solomon CG, Willett WC. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. N Engl J Med. 2001;345(11):790–7. https://doi.org/10.1056/NEJMoa010492.CrossRefPubMed

Koch T, Jenkin P, Kralik D. Chronic illness self-management: locating the “self”. J Adv Nurs. 2004;48:484–92.CrossRefPubMed

Corbin J, Strauss A. Unending work and care: managing chronic illness at home. San Francisco, CA: Jossey-Bass; 1988.

10.

Bodenheimer T, Wagner E, Grumbach K. Improving primary care for patients with chronic illness: the chronic care model. JAMA. 2002;288:1775–9.CrossRefPubMed

11.

Von Korff M, Gruman J, Schaefer J, Curry S, Wagner EH. Collaborative management of chronic illness. Ann Intern Med. 1997;127:1097–102.CrossRef

12.

Coleman K, Austin BT, Brach C, Wagner EH. Evidence on the chronic care model in the new millennium. Health Aff. 2009;28(1):75–85. https://doi.org/10.1377/hlthaff.28.1.75.CrossRef

13.

Furler J, Walker C, Blackberry I, Dunning T, Sulaiman N, Dunbar J, Young D. The emotional context of self-management in chronic illness: a qualitative study of the role of health professional support in the self-management of type 2 diabetes. BMC Health Serv Res. 2008;8(214). https://doi.org/10.1186/1472-6963-8-214.

14.

Dale J, Caramlau I, Docherty A, Sturt J, Hearnshaw H. Telecare motivational interviewing for diabetes patient education and support: a randomised controlled trial based in primary care comparing nurse and peer supporter delivery. Trials. 2007;8(18). https://doi.org/10.1186/1745-6215-8-18.

15.

Funnell MM. Peer-based behavioural strategies to improve chronic disease self-management and clinical outcomes: evidence, logistics, evaluation considerations and needs for future research. Family Practice, 27 Suppl. 2010;1(November 2008):17–22. https://doi.org/10.1093/fampra/cmp027.CrossRef

16.

Elissen A, Nolte E, Knai C, Brunn M, Chevreul K, Conklin A, Vrijhoef H. Is Europe putting theory into practice? A qualitative study of the level of self-management support in chronic care management approaches. BMC Health Serv Res. 2013;13(1):117. https://doi.org/10.1186/1472-6963-13-117.CrossRefPubMedPubMedCentral

17.

Norris SL, Engelgau MM, Venkat Narayan KM. Effectiveness of self-management training in type 2 diabetes: a systematic review of randomized controlled trials. Diabetes Care. 2001;24(3):561–87. https://doi.org/10.2337/diacare.24.3.561.CrossRefPubMed

18.

Barlow J, Wright C, Sheasby J, Turner A, Hainsworth J. Self-management approaches for people with chronic conditions: a review. Patient Educ Couns. 2002;48(2):177–87. https://doi.org/10.1016/S0738-3991(02)00032-0.CrossRefPubMed

19.

Street RL, Makoul G, Arora NK, Epstein RM. How does communication heal? Pathways linking clinician-patient communication to health outcomes. Patient Educ Couns. 2009;74(3):295–301. https://doi.org/10.1016/j.pec.2008.11.015.CrossRefPubMed

20.

Elissen A, Hertroijs D, Shaper N, Vrijhoef H, Ruwaard D. Profiling patients’ healthcare needs to support integrated, personcentered models for long-term disease management (Profile): research design. Int J Integr Care. 2016;16(2). https://doi.org/10.5334/ijic.2208.

21.

Gill P, Stewart K, Treasure E, Chadwick B. Methods of data collection in qualitative research: interviews and focus groups. Br Dent J. 2008;204(6):291–5. https://doi.org/10.1038/bdj.2008.192.CrossRefPubMed

22.

Hertroijs DFL, Elissen AMJ, Brouwers MCGJ, et al. A risk score including body massindex, glycated haemoglobin and triglycerides predicts future glycaemic control in people with type 2 diabetes. Diabetes Obes Metab. 2018;20:681–8. https://doi.org/10.1111/dom.13148.CrossRefPubMed

23.

Sanders EBN, Stappers P. Convivial Toolbox. Amsterdam: BIS Publishers; 2014.

24.

Thomas DR. A general inductive approach for analyzing qualitative evaluation data. Am J Eval. 2006;27(2):238–46.CrossRef

25.

Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M. European Association for the Study of diabetes (EASD). Management of hyperglycemia in type 2 diabetes: a patient-centered approach: position statement of the American Diabetes Association (ADA) and the European Association for the Study of diabetes (EASD). Diabetes Care. 2012;35(6):1364–79. https://doi.org/10.2337/dc12-0413.CrossRefPubMedPubMedCentral

26.

van HL, Rijken M, Heijmans M, Groenewegen P. Self-management support needs of patients with chronic illness: do needs for support differ according to the course of illness? Patient Educ Couns. 2013;93(3):626–32. https://doi.org/10.1016/j.pec.2013.08.021.CrossRef

27.

Lorig KR, Holman H. Self-management education: history, definition, outcomes, and mechanisms. Ann Behav Med. 2003;26:1–7.CrossRefPubMed

28.

Frei A, Svarin A, Steurer-Stey C, Puhan MA. Self-efficacy instruments for patients with chronic diseases suffer from methodological limitations - a systematic review. Health Qual Life Outcomes. 2009;7(86). https://doi.org/10.1186/1477-7525-7-86.

29.

Nolte E, Knai C, Saltman R. Assessing chronic disease management in European health systems : concepts and approaches. Copenhagen, Denmark: European Observatory on Health Systems and Policies, a partnership hosted by WHO; 2014.

30.

Powers MA, Bardsley J, Cypress M, Duker P, Funnell MM, Fischl AH, Vivian E. Diabetes self-management education and support in type 2 diabetes: a joint position statement of the American Diabetes Association, the American Association of Diabetes Educators, and the academy of nutrition and dietetics. J Acad Nutr Diet. 2015;115(8):1323–34. https://doi.org/10.1016/j.jand.2015.05.012.CrossRefPubMed

31.

Kujala S. User involvement: a review of the benefits and challenges. Behav Inform Technol. 2003;22(1):1–16. https://doi.org/10.1080/01449290301782.CrossRef

Title: Patients’ perspective on self-management: type 2 diabetes in daily life
Authors: Astrid N. van Smoorenburg
Dorijn F. L. Hertroijs
Tessa Dekkers
Arianne M. J. Elissen
Marijke Melles
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Care
Type 2 Diabetes
Published in: BMC Health Services Research / Issue 1/2019
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/s12913-019-4384-7

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Patients’ perspective on self-management: type 2 diabetes in daily life

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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