Collaborative care model for diabetes in primary care settings in Qatar: a qualitative exploration among healthcare professionals and patients who experienced the service

Abstract

Background Diabetes mellitus is highly prevalent and associated with huge economic burden globally. The conventional care and management of diabetes mellitus is highly fragmented and complex, warranting the need for a comprehensive Collaborative Care Model (CCM). Little is known about the perception of patients with diabetes and their healthcare providers about CCM, its barriers and facilitators. This study aimed to explore the value of CCM in diabetes care at a primary healthcare (PHC) setting from the perspective of patients with diabetes and healthcare professionals (HCPs), in an effort to expand our current knowledge on collaborative care in diabetes at primary care level for the purpose of quality improvement and service expansion. Methods Using an exploratory case study approach, semi-structured interviews were conducted among patients and HCPs who encountered CCM in Qatar during 2019 and 2020. The semi-structured interviews were transcribed verbatim and the data were analysed and interpreted using a deductive-inductive thematic analysis approach. Results Twelve patients and 12 HCPs at a diabetes clinic participated in one-to-one interviews. The interviews resulted in five different themes: the process and components of collaborative care model (four subthemes), current organizational support and resources (three subthemes), impact of collaborative care model on diabetes outcomes (three subthemes), enablers of collaborative care model (three subthemes), and barriers to collaborative care model (three subthemes). The participants indicated easy access to and communication with competent and pleasant HCPs. The patients appreciated the extra time spent with HCPs, frequent follow-up visits, and health education, which empowered them to self-manage diabetes. HCPs believed that successful CCM provision relied on their interest and commitment to care for patients with diabetes. Generally, participants identified barriers and facilitators that are related to patients, HCPs, and healthcare system. Conclusions The providers and users of CCM had an overall positive perception and appreciation of this model in PHC settings. Barriers to CCM such as undesirable attributes of HCPs and patients, unsupportive hospital system, and high workload must be addressed before implementing the model in other PHC settings.

What do patients experience? Interprofessional collaborative practice for chronic conditions in primary care: an integrative review

“…Across studies there was a total of n = 3803 participants, including patients, informal carers and family members. Studies were mostly conducted in the USA ( n = 13) [ 29 , 40 , 42 , 44 , 54 , 55 , 59 , 61 , 65 , 67 – 69 , 72 ], Australia ( n = 11) [ 26 – 28 , 30 , 34 , 36 , 41 , 52 , 57 , 63 , 66 ], UK ( n = 7) [ 31 , 39 , 46 – 48 , 53 , 60 ], Sweden ( n = 4) [ 38 , 49 – 51 ], Canada ( n = 3) [ 32 , 35 , 45 ] and The Netherlands ( n = 2) [ 9 , 64 ] with one study undertaken each in Belgium [ 62 ], Italy [ 71 ], France [ 33 ], New Zealand [ 43 ], Norway [ 58 ], Qatar [ 56 ] and, Spain [ 70 ], and one study conducted across multiple European countries [ 37 ]. Key characteristics of included studies are outlined in Additional file 3 .…”

Collaborative practice in type 2 diabetes management in a developing country: A qualitative study of perceptions and attitudes of key stakeholders

“…Nevertheless, the situation is likely to be more complex than ensuring the availability of an adequate health workforce. Even in developed countries with much higher levels of workforce participation, similar problems persist around collaboration (Abdulrhim et al, 2021; Schadewaldt et al, 2016). It, therefore, appears that this situation relates to intricate organisational systems and relationships rather than workforce shortages alone (Abdulrhim et al, 2021; Schneider et al, 2019).…”

What is meant by ‘integrated personalized diabetes management’: A view into the future and what success should look like

“…This allows resources in secondary and tertiary care to be saved for complex cases requiring specialized attention 46,47 . Primary care professionals are well suited to coordinate community resources to deliver IPDM services, as they are familiar with the local context and family situation of patients 48–50 …”

“…46,47 Primary care professionals are well suited to coordinate community resources to deliver IPDM services, as they are familiar with the local context and family situation of patients. [48][49][50] Patients with complex needs may require specialized examinations and advanced care management that cannot be provided by primary care alone. Care for patients with complex and unpredictable needs requires frequent and flexible interaction and coordination between primary, secondary and tertiary care as well as social care organizations.…”