Abstract
BackgroundFamily history (FH) is considered an important factor to detect individuals at increased risk developing type 2 diabetes (T2D). Moreover, FH information could be used to personalise risk messages, which are assumed to increase risk-reducing behaviours. In this study, we aimed to explore Dutch health care professionals’ attitudes regarding current or future uptake of a more extensive use of FH information and the family system in diabetes prevention.MethodsSemi-structured interviews were conducted with nineteen health care professionals from six general practices and four outpatient diabetes clinics. The use of FH information in opportunistic screening for T2D was explored, as well as the usability of a direct versus patient-mediated targeting strategy to reach persons with a FH of T2D. Three researchers analysed the interview transcripts separately.ResultsDutch health care professionals considered FH an important risk factor in opportunistic screening for T2D. However, none of them used FH to promote risk-reducing behaviours. Directly targeting and educating patients known to have a FH of T2D was desirable for most primary care professionals, but not considered feasible. Findings indicated that FH information was not systematically gathered in primary care settings and electronic medical records were not equipped to retrieve persons with T2D running in their family. The idea of asking patients to pass on risk and preventive information was new to all interviewees, but was considered an acceptable strategy to reach persons with a FH of diabetes. Nevertheless, there were concerns about the accuracy of the messages delivered by the patients to their relatives. Practical barriers with regard to time, expertise, and financial reimbursement were also mentioned.ConclusionsThere is great interest among healthcare professionals in primary as well as secondary care about the use of FH to prevent T2D, but there are significant barriers against such use. The removal of these barriers would depend on evidence showing the cost-effectiveness of FH-based strategies designed to prevent T2D.
Highlights
History (FH) is considered an important factor to detect individuals at increased risk developing type 2 diabetes (T2D)
According to the interviewees in primary care, the assessment of Family history (FH) information is not standardized; a person’s FH of diabetes is inquired the moment it is thought to be of relevance
Both in primary and secondary care, FH information is registered in electronic medical records (EMRs), but not with a retrievable code
Summary
History (FH) is considered an important factor to detect individuals at increased risk developing type 2 diabetes (T2D). FH information could be used to personalise risk messages, which are assumed to increase risk-reducing behaviours. We aimed to explore Dutch health care professionals’ attitudes regarding current or future uptake of a more extensive use of FH information and the family system in diabetes prevention. The rapidly increasing prevalence of T2D warrants major efforts to explore effective tools and strategies to detect, inform and motivate individuals at high risk to engage in preventive actions [2]. Evidence suggests that preventive messages tailored to a person’s FH can increase risk awareness and risk-reducing behaviours [10,11,12]. Interventions using FH information to promote a healthy lifestyle seem to be scarce [13]
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