Health care providers’ perspective on using family history in the prevention of type 2 diabetes: a qualitative study including different disciplines

Abstract

BackgroundFamily history (FH) is considered an important factor to detect individuals at increased risk developing type 2 diabetes (T2D). Moreover, FH information could be used to personalise risk messages, which are assumed to increase risk-reducing behaviours. In this study, we aimed to explore Dutch health care professionals’ attitudes regarding current or future uptake of a more extensive use of FH information and the family system in diabetes prevention.MethodsSemi-structured interviews were conducted with nineteen health care professionals from six general practices and four outpatient diabetes clinics. The use of FH information in opportunistic screening for T2D was explored, as well as the usability of a direct versus patient-mediated targeting strategy to reach persons with a FH of T2D. Three researchers analysed the interview transcripts separately.ResultsDutch health care professionals considered FH an important risk factor in opportunistic screening for T2D. However, none of them used FH to promote risk-reducing behaviours. Directly targeting and educating patients known to have a FH of T2D was desirable for most primary care professionals, but not considered feasible. Findings indicated that FH information was not systematically gathered in primary care settings and electronic medical records were not equipped to retrieve persons with T2D running in their family. The idea of asking patients to pass on risk and preventive information was new to all interviewees, but was considered an acceptable strategy to reach persons with a FH of diabetes. Nevertheless, there were concerns about the accuracy of the messages delivered by the patients to their relatives. Practical barriers with regard to time, expertise, and financial reimbursement were also mentioned.ConclusionsThere is great interest among healthcare professionals in primary as well as secondary care about the use of FH to prevent T2D, but there are significant barriers against such use. The removal of these barriers would depend on evidence showing the cost-effectiveness of FH-based strategies designed to prevent T2D.

Effect of non-soy legume consumption on inflammation and serum adiponectin levels among first-degree relatives of patients with diabetes: A randomized, crossover study

“…Diabetes is a multifactorial disease in which interaction of multiple genes and environmental factors can play an important role [1,2]. It has been demonstrated that individuals with a family history of diabetes are at two to five times higher risk for developing diabetes [3].…”

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“…Papers reported professional worries of being swamped and unable to manage the additional workload [43, 46, 51, 56], lack of time [44, 45, 54, 56–58], disturbed workflow [57], resources already being stretched [43, 51], and financial and organisational concerns [43, 45, 51, 53, 54, 57]:…”

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“…За да се одреди ризикот добро е да се воспостави прашалник кој би го одговориле пациентите или однапред испратен или при нивната посета. Фамилијарната историја е важна особено кај помладите пациенти [14]. Пациенти кои ги исполнуваат критериумите за дијагноза на дијабетес или зголемен ризик за дијабетес, се советуваат за прашања поврзани со намалување на ризикот од макроваскуларните болести (престанок на пушењето, употребата на аспирин, диета и вежбање), и треба да имаат мерења на крвниот притисок и серумските липиди редовно.…”

“…Релативно мали промени водат кон значајни промени во резултатите на студиите. Сеуште не е јасно дали раното откривање на дијабетес ќе го оправда финансискиот аспект на скринингот во превенирање на подоцнежните компликации [14].…”