Healthcare Professionals' Views of Factors Influencing Diabetes Self-Management and the Utility of a mHealth Application and Its Features to Support Self-Care.

Sungwon Yoon,Lian Leng Low,Jun Hao Ng,Yu Heng Kwan

doi:10.3389/fendo.2022.793473

Abstract

IntroductionThe perspectives of healthcare professionals (HCPs) are pivotal to co-development of self-management strategies for patients with diabetes. However, literature has been largely limited to perspectives of patients within the context of a Western healthcare setting. This study aims to explore factors influencing diabetes self-management in adult patients with diabetes from the perspectives of HCPs and their views of the value of mHealth application for diabetes self-management.Materials and MethodsWe conducted focus group discussions (FGD) with purposively selected HCPs in Singapore. All FGDs were audio-recorded and transcribed verbatim. Thematic analysis was conducted using NVivo 12.ResultsA total of 56 HCPs participated in the study. Barriers to self-management included limited patient commitment to lifestyle changes, suboptimal adherence to medication and treatment, patient resistance to insulin initiation and insufficient rapport between patients and HCPs. Patients’ perceived susceptibility to complications, social support from family and community, multidisciplinary team care and patient’s understanding of the benefits of self-care were viewed as facilitating self-management. HCPs saw mHealth apps as a vital opportunity to engage patients in the self-management of conditions and empower them to foster behavior changes. Yet, there were concerns regarding patient’s limited digital literacy, lack of integration into routine electronic system and reluctance.DiscussionWe identified a set of factors influencing self-management in adult patients with diabetes and useful app features that can empower patients to manage their conditions. Findings will inform the development of a mHealth application, and its features designed to improve self-care.

Highlights

The perspectives of healthcare professionals (HCPs) are pivotal to codevelopment of self-management strategies for patients with diabetes
We conducted focus group discussions (FGDs) with HCPs to elicit their perspectives of self-management in patients with diabetes and its integration with mobile health (mHealth), between May 2020 and February 2021
A majority of HCPs (46.4%) were from public primary care centers where a greater proportion of adult patients with diabetes in Singapore are being treated while 34% of HCPs were from diabetes centers in three tertiary hospitals which provide multidisciplinary services for diabetes management and education

Summary

Introduction

The perspectives of healthcare professionals (HCPs) are pivotal to codevelopment of self-management strategies for patients with diabetes. Diabetes mellitus is a chronic metabolic disease associated with serious complications and high healthcare cost, affecting 1 in 5 adults 65 years and above worldwide [1]. Older patients with diabetes are at risk of developing vascular complications, due to a longer disease duration and decline of physiological reserve [2]. These complications include retinopathy, nephropathy, neuropathy and heart diseases [3] which can negatively impact the quality of life and deepen the cost burden of disease. The increased socioeconomic burden associated with diabetes underscores the importance of early intervention to prevent and delay the complications resulting from the disease

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