scholarly journals Patient Work and Treatment Burden in Type 2 Diabetes: A Mixed-Methods Study

Author(s):  
Gabriela Spencer-Bonilla ◽  
Valentina Serrano ◽  
Catherine Gao ◽  
Manuel Sanchez ◽  
Katherine Carroll ◽  
...  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Stijn Crutzen ◽  
Tessa van den Born-Bondt ◽  
Petra Denig ◽  
Katja Taxis

Abstract Background Hypoglycaemia is a common and potentially avoidable adverse event in people with type 2 diabetes (T2D). It can reduce quality of life, increase healthcare costs, and reduce treatment success. We investigated self-management issues associated with hypoglycaemia and self-identified causes of hypoglycaemia in these patients. Methods In this mixed methods study qualitative semi-structured interviews were performed, which informed a subsequent quantitative survey in T2D patients. All interviews were audio recorded, transcribed verbatim and coded independently by two coders using directed content analysis, guided by the Theoretical Domains Framework. Descriptive statistics were used to quantify the self-management issues and causes of hypoglycaemia collected in the survey for the respondents that had experienced at least one hypoglycaemic event in the past. Results Sixteen participants were interviewed, aged 59–84 years. Participants perceived difficulties in managing deviations from routine, and they sometimes lacked procedural knowledge to adjust medication, nutrition or physical activity to manage their glucose levels. Grief and loss of support due to the loss of a partner interfered with self-management and lead to hypoglycaemic events. Work ethic lead some participant to overexerting themselves, which in turn lead to hypoglycaemic events. The participants had difficulties preventing hypoglycaemic events, because they did not know the cause, suffered from impaired hypoglycaemia awareness and/or did not want to regularly measure their blood glucose. When they did recognise a cause, they identified issues with nutrition, physical activity, stress or medication. In total, 40% of respondents reported regular stress as an issue, 24% reported that they regularly overestimated their physical abilities, and 22% indicated they did not always know how to adjust their medication. Around 16% of patients could not always remember whether they took their medication, and 42% always took their medication at regular times. Among the 83 respondents with at least one hypoglycaemic event, common causes for hypoglycaemia mentioned were related to physical activity (67%), low food intake (52%), deviations from routine (35%) and emotional burden (28%). Accidental overuse of medication was reported by 10%. Conclusion People with T2D experience various issues with self-managing their glucose levels. This study underlines the importance of daily routine and being able to adjust medication in relation to more physical activity or less food intake as well as the ability to reduce and manage stress to prevent hypoglycaemic events.


PLoS ONE ◽  
2018 ◽  
Vol 13 (12) ◽  
pp. e0207583 ◽  
Author(s):  
Nouf M. Aloudah ◽  
Neil W. Scott ◽  
Hisham S. Aljadhey ◽  
Vera Araujo-Soares ◽  
Khalid A. Alrubeaan ◽  
...  

Author(s):  
Thomas Karagiannis ◽  
Ioannis Avgerinos ◽  
Maria Toumpalidou ◽  
Aris Liakos ◽  
Konstantinos Kitsios ◽  
...  

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e022163
Author(s):  
Kathleen Yin ◽  
Teresa Harms ◽  
Kenneth Ho ◽  
Frances Rapport ◽  
Sanjyot Vagholkar ◽  
...  

IntroductionSelf-management is widely promoted but less attention is focused on the work required from patients. To date, many individuals struggle to practise self-management. ‘Patient work’, a concept that examines the ‘work’ involved in self-management, is an approach to understanding the tasks, effort, time and context from patient perspective. The purpose of our study is to use a novel approach combining non-obstructive observations via digital devices with in-depth qualitative data about health behaviours and motivations, to capture the full range of patient work experienced by people with type 2 diabetes and chronic comorbidities. It aims to yield comprehensive insights about ‘what works’ in self-management, potentially extending to populations with other chronic health conditions.Methods and analysisThis mixed-methods observational study involves a (1) prestudy interview and questionnaires, (2) a 24-hour period during which participants wear a camera and complete a time-use diary, and a (3) poststudy interview and study feedback. Adult participants living with type 2 diabetes with at least one chronic comorbidity will be recruited using purposive sampling to obtain a balanced gender ratio and of participants using insulin and those using only oral medication. Interviews will be analysed using thematic analysis. Data captured by digital devices, diaries and questionnaires will be used to analyse the duration, time, context and patterns of health-related behaviours.Ethics and disseminationThe study was approved by the Macquarie University Human Research Ethics Committee for Medical Sciences (reference number 5201700718). Participants will carry a wallet-sized card that explains the purpose of the study to third parties, and can remove the camera at any stage. Before the poststudy interview begins, participants will view the camera images in private and can delete any images. Should any images be used in future publications or presentations, identifying features such as human faces and names will be obscured.


2013 ◽  
Vol 7 (4) ◽  
pp. 261-267 ◽  
Author(s):  
Navneet Aujla ◽  
Margaret A. Stone ◽  
Nicholas Taub ◽  
Melanie J. Davies ◽  
Kamlesh Khunti

2016 ◽  
Vol 30 (3) ◽  
pp. 385-393 ◽  
Author(s):  
P. D. McArdle ◽  
S. M. Greenfield ◽  
A. Avery ◽  
G. G. Adams ◽  
P. S. Gill

2016 ◽  
Vol 4 (1) ◽  
pp. e000212 ◽  
Author(s):  
Jeffrey T Kullgren ◽  
Megan Knaus ◽  
Kristi Rahrig Jenkins ◽  
Michele Heisler

10.2196/13986 ◽  
2019 ◽  
Vol 8 (6) ◽  
pp. e13986
Author(s):  
Rajna Ogrin ◽  
Sandra Neoh ◽  
Tracy Aylen ◽  
Ralph Audehm ◽  
Leonid Churilov ◽  
...  

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