Abstract
BackgroundDeficiencies in the quality of diabetes and hypertension primary care and outcomes have been documented in Barbados. This study aimed to explore the knowledge, attitudes and practices, and the barriers faced by people with diabetes and hypertension in Barbados that might contribute to these deficiencies.MethodsFive structured focus groups were conducted for randomly selected people with diabetes and hypertension.ResultsTwenty-one patients (5 diabetic, 5 hypertensive, and 11 with both diseases) with a mean age of 59 years attended 5 focus group sessions.Patient factors that affected care included the difficulty in maintaining behaviour change. Practitioner factors included not considering the "whole person" and patient expectations, and not showing enough respect for patients. Health care system factors revolved around the amount of time spent accessing care because of long waiting times in public sector clinics and pharmacies. Society related barriers included the high cost and limited availability of appropriate food, the availability of exercise facilities, stigma of disease and difficulty taking time off work.Attendees were not familiar with guidelines for diabetes and hypertension management, but welcomed a patient version detailing a place to record results, the frequency of tests, and blood pressure and blood glucose targets. Appropriate education from practitioners during consultations, while waiting in clinic, through support and education groups, and for the general public through the schools, mass media and billboards were recommended.ConclusionsPrimary care providers should take a more patient centred approach to the care of those with diabetes and hypertension. The care system should provide better service by reducing waiting times. Patient self-management could be encouraged by a patient version of care guidelines and greater educational efforts.
Highlights
Deficiencies in the quality of diabetes and hypertension primary care and outcomes have been documented in Barbados
Primary care of diabetes and hypertension is delivered through public sector polyclinics at no cost, or by private general practitioners for a fee (Table 1)
It was assumed that all attendees with diabetes had type 2
Summary
Deficiencies in the quality of diabetes and hypertension primary care and outcomes have been documented in Barbados. Primary care of diabetes and hypertension is delivered through public sector polyclinics at no cost, or by private general practitioners for a fee (Table 1). Patients in both sectors are provided, at no cost under the Barbados Drug Benefit Service, with an appropriate range of medications to treat diabetes and hypertension. Audits of diabetes and hypertension care in Barbados have, indicated that deficiencies exist in the quality of care and Public sector
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