The burden of treatment in people living with type 2 diabetes: A qualitative study of patients and their primary care clinicians.

<h4>Background</h4>The burden of treatment can overwhelm people living with type 2 diabetes and lead to poor treatment fidelity and outcomes. Chronic care programs must consider and mitigate the burden of treatment while supporting patients in achieving their goals.<h4>Objective<...

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Main Authors: Pilar Espinoza, Camila A Varela, Ivonne E Vargas, Galo Ortega, Paulo A Silva, Kasey B Boehmer, Victor M Montori
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2020-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0241485
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author Pilar Espinoza
Camila A Varela
Ivonne E Vargas
Galo Ortega
Paulo A Silva
Kasey B Boehmer
Victor M Montori
author_facet Pilar Espinoza
Camila A Varela
Ivonne E Vargas
Galo Ortega
Paulo A Silva
Kasey B Boehmer
Victor M Montori
author_sort Pilar Espinoza
collection DOAJ
description <h4>Background</h4>The burden of treatment can overwhelm people living with type 2 diabetes and lead to poor treatment fidelity and outcomes. Chronic care programs must consider and mitigate the burden of treatment while supporting patients in achieving their goals.<h4>Objective</h4>To explore what patients with type 2 diabetes and their health providers consider are the workload and the resources they must mobilize, i.e., their capacity, to shoulder it.<h4>Methods</h4>We conducted focus groups comprised of 30 patients and 32 clinicians from three community health centers in Chile implementing the Chronic Care Model to reduce cardiovascular risk in patients with type 2 diabetes. Transcripts were analyzed using thematic content analysis techniques illuminated by the Minimally Disruptive Medicine framework.<h4>Findings</h4>Gaining access to and working with their clinicians, implementing complex medication regimens, and changing lifestyles burdened patients. To deal with the distress of the diagnosis, difficulties achieving disease control, and fear of complications, patients drew capacity from their family (mostly men), social environment (mostly women), lay expertise, and spirituality. Clinicians found that administrative tasks, limited formulary, and protocol rigidity hindered their ability to modify care plans to reduce patient workload and support their capacity.<h4>Conclusions</h4>Chronic primary care programs burden patients living with type 2 diabetes while hindering clinicians' ability to reduce treatment workloads or support patient capacity. A collaborative approach toward Minimally Disruptive Medicine may result in treatments that fit the lives and loves of patients and improve outcomes.
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spelling doaj.art-fbcded7c630d497e9b0e81d67ba5ed392022-12-22T02:59:47ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-011510e024148510.1371/journal.pone.0241485The burden of treatment in people living with type 2 diabetes: A qualitative study of patients and their primary care clinicians.Pilar EspinozaCamila A VarelaIvonne E VargasGalo OrtegaPaulo A SilvaKasey B BoehmerVictor M Montori<h4>Background</h4>The burden of treatment can overwhelm people living with type 2 diabetes and lead to poor treatment fidelity and outcomes. Chronic care programs must consider and mitigate the burden of treatment while supporting patients in achieving their goals.<h4>Objective</h4>To explore what patients with type 2 diabetes and their health providers consider are the workload and the resources they must mobilize, i.e., their capacity, to shoulder it.<h4>Methods</h4>We conducted focus groups comprised of 30 patients and 32 clinicians from three community health centers in Chile implementing the Chronic Care Model to reduce cardiovascular risk in patients with type 2 diabetes. Transcripts were analyzed using thematic content analysis techniques illuminated by the Minimally Disruptive Medicine framework.<h4>Findings</h4>Gaining access to and working with their clinicians, implementing complex medication regimens, and changing lifestyles burdened patients. To deal with the distress of the diagnosis, difficulties achieving disease control, and fear of complications, patients drew capacity from their family (mostly men), social environment (mostly women), lay expertise, and spirituality. Clinicians found that administrative tasks, limited formulary, and protocol rigidity hindered their ability to modify care plans to reduce patient workload and support their capacity.<h4>Conclusions</h4>Chronic primary care programs burden patients living with type 2 diabetes while hindering clinicians' ability to reduce treatment workloads or support patient capacity. A collaborative approach toward Minimally Disruptive Medicine may result in treatments that fit the lives and loves of patients and improve outcomes.https://doi.org/10.1371/journal.pone.0241485
spellingShingle Pilar Espinoza
Camila A Varela
Ivonne E Vargas
Galo Ortega
Paulo A Silva
Kasey B Boehmer
Victor M Montori
The burden of treatment in people living with type 2 diabetes: A qualitative study of patients and their primary care clinicians.
PLoS ONE
title The burden of treatment in people living with type 2 diabetes: A qualitative study of patients and their primary care clinicians.
title_full The burden of treatment in people living with type 2 diabetes: A qualitative study of patients and their primary care clinicians.
title_fullStr The burden of treatment in people living with type 2 diabetes: A qualitative study of patients and their primary care clinicians.
title_full_unstemmed The burden of treatment in people living with type 2 diabetes: A qualitative study of patients and their primary care clinicians.
title_short The burden of treatment in people living with type 2 diabetes: A qualitative study of patients and their primary care clinicians.
title_sort burden of treatment in people living with type 2 diabetes a qualitative study of patients and their primary care clinicians
url https://doi.org/10.1371/journal.pone.0241485
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