General practitioners' attitudes towards patients with poorly controlled type 2 diabetes: a qualitative study

Area of Science:

• General Practice
• Endocrinology
• Qualitative Research

Background:

• Managing type 2 diabetes mellitus (T2DM) with poor glycaemic control presents challenges for general practitioners (GPs).
• Understanding GP attitudes is crucial for improving T2DM patient management.
• Patient-related factors and GP perspectives influence treatment outcomes.

Purpose of the Study:

• To investigate the attitudes of general practitioners (GPs) towards patients with type 2 diabetes mellitus (T2DM) exhibiting poor metabolic control.
• To identify key themes in GP perceptions of managing difficult-to-control T2DM cases.

Main Methods:

• Qualitative study involving 20 general practitioners (GPs) in German general practice.
• In-depth narrative interviews were conducted, audio-recorded, transcribed, and analyzed using inductive coding.
• A multi-professional team abstracted major themes related to GP attitudes.

Main Results:

• GPs exhibit varied attitudes, including a focus on laboratory parameters for security, feelings of resignation, devaluation of patients due to perceived non-compliance, a fixed expert-patient role structure, and a desire for solidarity.
• Key themes identified were: orientation on lab parameters, resignation, patient devaluation, fixed role structure, and solidarity.

Conclusions:

• GPs experience internal conflict between duty and futility, leading to insecurity and feelings of defeat.
• Optimizing the doctor-patient relationship by establishing shared, realistic goals can benefit both GPs and T2DM patients.
• A partnership approach in defining authentic goals is recommended for improved T2DM management.