PMID- 31377711
OWN - NLM
STAT- MEDLINE
DCOM- 20200922
LR  - 20221207
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 9
IP  - 8
DP  - 2019 Aug 2
TI  - Process evaluation of team-based care in people aged >65 years with type 2 
      diabetes mellitus.
PG  - e029965
LID - 10.1136/bmjopen-2019-029965 [doi]
LID - e029965
AB  - OBJECTIVE: The prevalence of type 2 diabetes mellitus (T2DM) is increasing 
      globally and there is critical need develop interventions to improve health 
      outcomes among older people. The Group Appointments in Primary Care (GAP) study 
      was a randomised controlled trial designed to test the efficacy of a group and 
      team-based medical visit programme to lower haemoglobin A1c among patients with 
      T2DM. We aimed to understand the barriers and facilitators to implement the GAP 
      intervention within a primary care setting, with an emphasis on patient 
      experience. RESEARCH DESIGN AND METHODS: This was a qualitative exploratory 
      study. Data were gathered from semistructured interviews conducted with the first 
      cohort of GAP study participants (n=15) at baseline and intervention completion. 
      GAP participants were aged >65, diagnosed with T2DM and from one primary care 
      clinic. The interview questions identified the patient perspectives and factors 
      relating to their attendance at seven group medical visits that were part of the 
      intervention programme. Data were analysed using framework analysis. RESULTS: We 
      identified four themes that captured participants' experiences: (1) Education: 
      learning with professionals, learning with one another; (2) Social Support: 
      common interests, common problems; (3) Setting: ease of location, ease of 
      conversation and (4) Impact: expectations met, empowerment gained. The GAP 
      intervention increased participants' self-reported diabetes literacy and 
      self-management skills. CONCLUSIONS: We learnt that: accessible community 
      centres, not primary care offices, were the ideal location for GAP; the 
      consistent leadership of the primary care physician was valued by participants; 
      and, the content related to exercise and healthy diet were viewed as impactful. 
      Also, learning was achieved through content delivered by clinical experts, and by 
      T2DM experts with lived experience-the GAP peers. Our findings highlight the 
      important role of group learning. TRIAL REGISTRATION NUMBER: NCT02002143.
CI  - (c) Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Sims Gould, Joanie
AU  - Sims Gould J
AUID- ORCID: 0000-0003-1260-5405
AD  - Centre for Hip Health and Mobility, University of British Columbia, Vancouver, 
      British Columbia, Canada simsg@mail.ubc.ca.
AD  - Department of Family Practice, University of British Columbia, Vancouver, British 
      Columbia, Canada.
FAU - Tong, Catherine
AU  - Tong C
AD  - Centre for Hip Health and Mobility, University of British Columbia, Vancouver, 
      British Columbia, Canada.
FAU - Ly, Jessica
AU  - Ly J
AD  - Centre for Hip Health and Mobility, University of British Columbia, Vancouver, 
      British Columbia, Canada.
FAU - Vazirian, Sara
AU  - Vazirian S
AD  - Centre for Hip Health and Mobility, University of British Columbia, Vancouver, 
      British Columbia, Canada.
FAU - Windt, Adriaan
AU  - Windt A
AD  - Centre for Hip Health and Mobility, University of British Columbia, Vancouver, 
      British Columbia, Canada.
FAU - Khan, Karim
AU  - Khan K
AD  - Centre for Hip Health and Mobility, University of British Columbia, Vancouver, 
      British Columbia, Canada.
AD  - Department of Family Practice, University of British Columbia, Vancouver, British 
      Columbia, Canada.
LA  - eng
SI  - ClinicalTrials.gov/NCT02002143
GR  - CIHR/Canada
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20190802
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
RN  - 0 (Glycated Hemoglobin A)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - British Columbia
MH  - Community Health Centers
MH  - Diabetes Mellitus, Type 2/psychology/*therapy
MH  - Diet, Healthy
MH  - Exercise
MH  - Glycated Hemoglobin/analysis
MH  - Health Services Accessibility
MH  - Humans
MH  - Leadership
MH  - Learning
MH  - Patient Care Team/*organization & administration
MH  - *Patient Education as Topic
MH  - *Primary Health Care
MH  - *Process Assessment, Health Care
MH  - Proof of Concept Study
MH  - Single-Blind Method
MH  - Social Support
PMC - PMC6687023
OTO - NOTNLM
OT  - general diabetes
OT  - geriatric medicine
OT  - qualitative research
OT  - team-based care
COIS- Competing interests: None declared.
EDAT- 2019/08/05 06:00
MHDA- 2020/09/23 06:00
PMCR- 2019/08/02
CRDT- 2019/08/05 06:00
PHST- 2019/08/05 06:00 [entrez]
PHST- 2019/08/05 06:00 [pubmed]
PHST- 2020/09/23 06:00 [medline]
PHST- 2019/08/02 00:00 [pmc-release]
AID - bmjopen-2019-029965 [pii]
AID - 10.1136/bmjopen-2019-029965 [doi]
PST - epublish
SO  - BMJ Open. 2019 Aug 2;9(8):e029965. doi: 10.1136/bmjopen-2019-029965.