'Managing patient involvement': provider perspectives on diabetes decision-making

Area of Science:

• Primary Care
• Health Psychology
• Medical Decision Making

Background:

• Shared decision-making (SDM) research predominantly focuses on acute care, neglecting chronic disease management.
• A significant portion of primary care involves managing patients with long-term conditions.

Purpose of the Study:

• To explore healthcare provider viewpoints on the significance of patient engagement in chronic disease decision-making.
• Investigate how providers navigate patient involvement in diabetes care planning.

Main Methods:

• Qualitative study utilizing grounded theory.
• Interviews conducted with 29 healthcare providers involved in diabetes care planning, including general practitioners, allied health professionals, and endocrinologists.

Main Results:

• Providers experience a conflict between delivering evidence-based care and respecting patient autonomy.
• Two approaches emerged: 'treating to target' (more assertive, focused on evidence) and 'personalized care' (more accepting of patient priorities).
• Patient involvement was managed to align with provider objectives, either to tailor care within set targets or to incorporate patient preferences more broadly.

Conclusions:

• Providers value both patient autonomy and high-quality diabetes care, recognizing the need for a delicate balance.
• Patient involvement in decision-making can be a strategy to achieve this balance, rather than an ultimate goal in itself.