Patients are unaware of clinical recommendations and resources

The Emory Family Medicine Clinic (EFMC) sought to identify perceptions of recent patient-provider communications for patients with diabetes, factors influencing patient compliance with clinical recommendations, and patients' desire for additional resources to facilitate diabetes management.

Four focus group discussions were held June-August 2018 (3-9 participants each, 21 total). EFMC patients with uncontrolled diabetes received a phone invitation. A template analytic strategy, characterized by an initial set of codes based on interview content and expected types of responses and inductive codes, was used to thematically code the data.

Most participants were single (62%), college educated (62%), had incomes less than $60,000 (76%), and were younger than 50 years old (62%). For themes related to barriers to compliance the participants mentioned the "business of medicine," convenience factors, food choices, accountability, feeling overwhelmed, costs, location/transportation, and miscommunications. Prevailing themes regarding facilitating compliance included a desire for help with self-accountability and prioritization of recommendations. The major desired patient resource was peer-support groups.

Patient understanding of the impact diabetes has on their life can affect adherence to treatment; hence patient education is critical. Payment policies should support innovative educational clinical visits with patients.