Identification of Important Factors Affecting Use of Digital Individualised Coaching and Treatment of Type 2 Diabetes in General Practice: A Qualitative Feasibility Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Recruitment and Participants
2.2. Data Collection
2.3. Data Analysis
3. Results
3.1. Theme 1: Distribution of Roles and Lifestyle Interventions in General Practice
3.1.1. Subtheme: External Distribution of Roles
“We do not receive any reporting from the municipality when we refer our patients to diabetes courses.”(GP 1,1)
“We do, I read it every time. The report describes that the patient has participated in a diabetes course with good effects, but well—The information is not that useful.”(PN 1,1)
“If they talk to the coach about lifestyle issues one day, they do not need to come and talk to me about the same things the same day. I think we need to make an agreement about what they discuss with the coach and what they discuss with me.”(PN 2,1)
3.1.2. Subtheme: Internal Distribution of Roles
“We have an agreement that it is the PN’s responsibility to refer the patients to the courses and follow up on what is happening in the municipality.”(GP 4,2)
“I talk about diet, physical activity, smoking cessation and alcohol in overall terms. I do not go into details with counting steps and so.”(GP 3,1)
“Well, I go a lot into details about steps. I experience that many of my patients are wearing a step counter. I think it’s an easy and concrete way of discussing their physical activity level.”(GP 3,2)
3.2. Theme 2: Pros and Cons for Digital Lifestyle Interventions in General Practice
3.2.1. Subtheme: Access to Real Life Data
“I think this is really helpful to have this motivational talk with the patients. Because, we know our patients and we all know that they do not follow our recommendations when they get home. This eHealth tool will help us to better understand what the barriers and challenges are in adopting a healthier lifestyle. And if the patient succeeds taking more steps for instance, he will become so happy when he gets his results from his blood tests.”(PN 2,1)
“I can imagine the gains, if we by using the real life data on my screen in the consultation can set up more realistic and concrete goals instead of just telling the patient to walk and cycle a little more. With this app you can say, now you take 1500 steps per day. How can we increase that to 7000?”(GP 1,1)
“We only have 15 min when we see the patient, and in addition to look on the screen we also need to talk to them.”(GP 4,1)
“I need to know what exactly I should say to the patient within 30 s, because I do not have more time than that to clarify and nuance the data shown on the screen.”(PN 1,1)
“Well it opens for a lot of questions, and we do not have more time to the patients.”(PN 3,2)
“I agree. We do not need more registration tasks, and I suspect a little extra time-consuming registration unless you become so familiar with this platform, so you get a quick overview very easily.”(GP 3,1)
3.2.2. Subtheme: Change in Daily Routines
“If this is going to work in daily practice, it is important that it is easily accessible and that it runs perfectly from the very beginning.”(GP 4,1)
“There need to be an icon that works. It should only take one extra click to get the data, and it should be easy to get an overview. Then I would use it when the patient visits me in the motivational conversation with the patient and to point out the good things.”(GP 2,1)
“If this requires more consultations, it means no thanks from me.”(PN 3,2)
“We have to be aware about the number of consultations per year since we get a fixed fee per year per T2D patient.”(PN 3,2)
“We will enter into an agreement with the patients about when we will look at their data, because we do not follow up on them every day.”(PN 2,1)
“I think that this will make me feel that both I and the patient are getting more out of the consultation. Our routine practice is that we see the patients every third month, but if we are getting more real-life data to work with it will be more interesting to see the patient one time per month.”(GP 2,1)
4. Discussion
4.1. Strengths and Limitations
4.2. Practical Implications and Recommendations for Further Research
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Step | Description |
---|---|
I | Familiarisation with data (PRJ, CJB) |
II | Inductive coding of data (PRJ and CJB coded data independently and generated an initial list of ideas about what is in the data) |
III | Discussion of codes and consensus reached of emerging themes (PRJ, CJB, JRC, JBN, JS) |
IV | Review of the themes whereby a set of subthemes were explored and refined, including similarities and differences between interviews (PRJ, CJB, JRC, JBN, JS) |
V | Themes and subthemes reviewed, revised, and agreed upon, and results summarised and described in the paper (PRJ, CJB, JRC, JBN, JS). |
General Practice and Geography | Number of Registered Patients | Participants | Gender |
---|---|---|---|
Practice no. 1 | 4000 | GP 1.1 | M |
Rural | GP 1.2 | M | |
GP 1.3 | M | ||
PN 1.1 | F | ||
PN 1.2 | F | ||
Practice no. 2 | 3000 | GP 2.1 | M |
Urban | PN 2.1 | F | |
Practice no. 3 | 6000 | GP 3.1 | M |
Urban | GP 3.2 | M | |
GP 3.3 | M | ||
PN 3.1 | F | ||
PN 3.2 | F | ||
Practice no. 4 | 7500 | GP 4.1 | F |
Rural | GP 4.2 | F | |
PN 4.1 | F |
Theme 1. Distribution of Roles and Lifestyle Interventions in General Practice | Theme 2. Pros and Cons for Digital Lifestyle Interventions in General Practice |
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External distribution of roles | Access to real life data |
Internal distribution of roles | Change in daily routines |
Identified Factors of Importance |
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Jakobsen, P.R.; Christensen, J.R.; Nielsen, J.B.; Søndergaard, J.; Ejg Jarbøl, D.; Olsen, M.H.; Nielsen, J.S.; Kristensen, J.K.; Brandt, C.J. Identification of Important Factors Affecting Use of Digital Individualised Coaching and Treatment of Type 2 Diabetes in General Practice: A Qualitative Feasibility Study. Int. J. Environ. Res. Public Health 2021, 18, 3924. https://doi.org/10.3390/ijerph18083924
Jakobsen PR, Christensen JR, Nielsen JB, Søndergaard J, Ejg Jarbøl D, Olsen MH, Nielsen JS, Kristensen JK, Brandt CJ. Identification of Important Factors Affecting Use of Digital Individualised Coaching and Treatment of Type 2 Diabetes in General Practice: A Qualitative Feasibility Study. International Journal of Environmental Research and Public Health. 2021; 18(8):3924. https://doi.org/10.3390/ijerph18083924
Chicago/Turabian StyleJakobsen, Pernille Ravn, Jeanette Reffstrup Christensen, Jesper Bo Nielsen, Jens Søndergaard, Dorte Ejg Jarbøl, Michael Hecht Olsen, Jens Steen Nielsen, Jette Kolding Kristensen, and Carl J. Brandt. 2021. "Identification of Important Factors Affecting Use of Digital Individualised Coaching and Treatment of Type 2 Diabetes in General Practice: A Qualitative Feasibility Study" International Journal of Environmental Research and Public Health 18, no. 8: 3924. https://doi.org/10.3390/ijerph18083924