Patient Perceptions About Prediabetes and Preferences for Diabetes Prevention

Abstract

Purpose The purpose of this study was to explore how adults with prediabetes perceive their risk of developing diabetes and examine their preferences for evidence-based treatment options to prevent diabetes. Methods A qualitative study was conducted in 2 large Midwest primary care practices, involving in-depth semistructured interviews with 35 adult patients with prediabetes. Results This ethnically diverse (77% nonwhite) sample of middle-aged primary care patients exhibited multiple diabetes risk factors. Knowledge gaps about prediabetes and its medical management were pervasive. Most patients overestimated the risk of developing diabetes and were not familiar with evidence-based treatment options for prediabetes. They suggested that receiving brief, yet specific information about these topics during the study interview motivated them to act. The majority of participants considered both intensive lifestyle intervention and metformin acceptable treatment options. Many preferred initial treatment with intensive lifestyle intervention but would take metformin if their efforts at lifestyle change failed and their primary care physician recommended it. Some participants expressed wanting to combine both treatments. Conclusions This qualitative study highlights potential opportunities to promote patient-centered dialogue about prediabetes in primary care settings. Providing patients specific information about the risk of developing diabetes and evidence-based treatment options to prevent or delay its onset may encourage action. Physicians’ prediabetes counseling efforts should be informed by the finding that most patients consider both intensive lifestyle intervention and metformin acceptable treatment options.

‘I’m on the train and I can't stop it': Western Canadians' reactions to prediabetes and the role of self-compassion

“…Participants were concerned about progressing to T2D, experiencing physical ailments associated with T2D, and exacerbating current health conditions. These findings are consistent with past research where physical concerns (Eborall et al, ), uncertainty about seriousness of the diagnosis (O'Brien et al, ; Troughton et al, ) and implications for current health problems (Peel, Parry, Douglas, & Lawton, ) have been documented. These concerns may be fuelled by uncertainty around what a prediabetes diagnosis actually means and poor communication about the diagnosis by healthcare providers (O'Brien et al, ).…”

“…First, healthcare professionals should be aware of the negative reactions people have upon learning about their prediabetes diagnosis and take steps to reduce these reactions. Healthcare professionals could offer patients with prediabetes a clear explanation of what prediabetes is, the health implications, the likelihood that they will develop T2D, and the risk‐reducing efficacy of lifestyle changes (O'Brien et al, ). This clear, unambiguous communication about prediabetes may mitigate distress associated with uncertainty.…”

“…Healthcare professionals could offer patients with prediabetes a clear explanation of what prediabetes is, the health implications, the likelihood that they will develop T2D, and the risk-reducing efficacy of lifestyle changes (O'Brien et al, 2016). This clear, unambiguous communication about prediabetes may mitigate distress associated with uncertainty.…”

“…An exploratory qualitative design was chosen to gain an in‐depth understanding of participants' perspectives (Ritholz et al, ). An interview guide was developed based on an extensive literature review (see Table for sample questions from the interview guide; e.g., Andersson et al, ; O'Brien et al, ; Troughton et al, ). Interviews were conducted by the first two authors.…”

Self-reported awareness and attitude of cancer patients towards clinical nurse coordinators

“…[16,17] A study stated that the patients' perception can be influenced by their pre-service expectations of the service provider [18] that is the patients' actual knowledge of the roles and responsibilities of CNCs in this study. Another study reported that patients' perceptions of disease risks and development influenced their attitude towards treatment preferences, [19] and that an effective communication about prognosis is a prerequisite to define goals of care, making treatment decisions, and planning for the future. [20] This clearly indicates how nourishing the knowledge of cancer patients and enhancing their perception can influence their attitude to communicate such needs to CNCs.…”