Patient Perspectives of the Operationalization of Adult Patient-centred Care at the Primary Care Diabetes Support...

Patient-centred care is a hallmark of family medicine, and patient-centred care for diabetes has been associated with better outcomes. The Primary Care Diabetes Support Program (PCDSP) in London, Ontario, uses a patient-centred model of care and targets 3 groups of patients at high risk for diabetes complications: 1) medically complex, 2) socially complex, and 3) those without a primary care provider. We describe, from the patients' perspectives, how the PCDSP operationalizes patient-centred care.

Using maximum variation sampling, we recruited and interviewed 17 patients regarding their experiences with the PCDSP. We asked patients about the PCDSP's approach to care and its impact on their diabetes management and overall health. We coded interview transcripts using an inductive thematic analysis approach.

We identified 8 attributes of PCDSP care that aligned with the principles of patient-centred care: 1) reassurance, 2) education, 3) whole-person care, 4) individualized care, 5) high accessibility, 6) coordinated care, 7) integration of new technologies, and 8) ownership of care. Participants emphasized that they felt the care they received from the PCDSP was tailored to their individual needs; offered accessible, coordinated care with other providers; and gave them access to new medications and technologies as well as the latest research on diabetes care.

Our findings highlight that the PCDSP approach is more holistic than existing patient-centred care models for diabetes described in the literature, which have focussed on education and skills to improve self-management. The attributes identified are mutually reinforcing and our findings reflect a longitudinal, high-quality primary care approach through the PCDSP.