Exploring the process when developing a lifestyle intervention in primary care for type 2 diabetes: a longitudinal...

Area of Science:

• Health Services Research
• Primary Care Medicine
• Diabetes Management

Background:

• Bridging the gap between lifestyle intervention research and primary care practice requires understanding implementation processes.
• Lifestyle interventions are crucial for managing type 2 diabetes mellitus (T2DM).

Purpose of the Study:

• To explore the processes involved in delivering a lifestyle intervention to T2DM patients by healthcare professionals in primary care.
• To identify barriers and facilitators for effective lifestyle intervention implementation in routine care.

Main Methods:

• A mixed-methods approach was employed, combining qualitative and quantitative data.
• Data collection included serial interviews with healthcare professionals and patients, recorded consultations, activity questionnaires, and biomedical data.
• Qualitative data were analyzed using framework analysis with a phenomenological approach.

Main Results:

• The intervention, involving motivational interviewing and a multidisciplinary team, led to increased patient activity, weight loss, and improved glycated haemoglobin levels.
• Patients remained passive during consultations and did not actively seek lifestyle improvement information.
• Diabetes practice nurses (DPNs) did not fully utilize motivational interviewing and provided information that was difficult for patients to understand.

Conclusions:

• Delivering effective lifestyle interventions for T2DM in primary care presents significant challenges.
• DPNs need to adapt their communication to patients' knowledge levels and encourage active patient participation.
• Establishing patients and healthcare professionals as equal partners in goal setting is essential for successful treatment plans.