Perspectives and Experiences of Health Care Professionals and Patients with Diabetes regarding Self-Monitoring of Blood Glucose in Canada

Abstract

Objective: To explore the current perspectives and experiences of Canadian health care professionals and patients with diabetes regarding self-monitoring of blood glucose (SMBG). Design: Qualitative analysis of focus groups in Ottawa, Vancouver and Edmonton. Methods: Seventeen focus groups involving 59 health care professionals (19 pharmacists, 18 certified diabetes educators and 22 physicians) and 40 patients with type 1 or type 2 diabetes were held, using separate moderator's guides. Thematic analysis was used to analyze responses. Results: Health care professionals reported recommending SMBG to most patients with diabetes, regardless of insulin use. They also reported periodically reviewing glucometer results, providing education on interpreting the results and proper use of SMBG devices. The majority of patients with diabetes indicated that they regularly monitored their blood glucose levels and recorded their results. Advantages of SMBG cited by health care professionals included a sense of control over diabetes, the ability to make lifestyle and treatment choices and increased patient confidence. Patients listed expense, discomfort and inconvenience as disadvantages to SMBG. Although patients discussed SMBG readings with their health care professionals, many reported that treating physicians were often uninterested in SMBG results. Physicians tended to refer to SMBG in the context of disease-specific benefits, while certified diabetes educators more often cited the psychological and educational benefits of SMBG. Compared with physicians, pharmacists focused more on the lifestyle and educational benefits of SMBG rather than on changes to medications. Conclusion: SMBG is commonly recommended by health care professionals and regularly performed by most patients with diabetes. Pharmacists and other health care professionals play an important role in educating patients on the appropriate use of SMBG and interpretation of results. To ensure optimal use, pharmacists and other health care providers should review the desired outcomes of SMBG with patients on a regular basis.