The burden of treatment in people living with type 2 diabetes: A qualitative study of patients and their primary care clinicians.
The burden of treatment in people living with type 2 diabetes: A qualitative study of patients and their primary care clinicians.
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DOI：
10.1371/journal.pone.0241485
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发表时间：
2020
期刊：
影响因子：
3.7
通讯作者：
Montori VM
中科院分区：
文献类型：
--
作者：
Espinoza P;Varela CA;Vargas IE;Ortega G;Silva PA;Boehmer KB;Montori VM
治疗负担可能会使2型糖尿病患者不堪重负，并导致治疗保真度和结果较差。慢性病护理计划必须考虑并减轻治疗负担，同时支持患者实现其目标。探讨2型糖尿病患者及其健康提供者认为他们必须动员的工作量和资源，即，我们对来自智利三个社区卫生中心的30名患者和32名临床医生进行了焦点小组研究，实施慢性护理模式，以降低2型糖尿病患者的心血管风险。转录本进行了分析，使用主题内容分析技术照亮的最小中断医学框架。获得接触并与他们的临床医生合作，实施复杂的药物治疗方案，改变生活方式给患者带来负担。为了应对诊断的痛苦，疾病控制的困难，以及对并发症的恐惧，患者从他们的家庭（主要是男性），社会环境（主要是女性），非专业知识和灵性中汲取能力。临床医生发现，行政任务，有限的处方集和协议的刚性阻碍了他们修改护理计划，以减少病人的工作量和支持他们的能力。慢性初级保健计划给2型糖尿病患者带来负担，同时阻碍临床医生减少治疗工作量或支持患者能力的能力。针对最小干扰医学的协作方法可能会产生适合患者生活和爱好的治疗方法并改善结果。
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. 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. 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. 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. 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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影响因子：
2.2
作者：
Polonsky WH;Henry RR
通讯作者：
Henry RR
影响因子：
5.7
作者：
Spencer-Bonilla, Gabriela;Quinones, Ana R.;Montori, Victor M.
通讯作者：
Montori, Victor M.
影响因子：
39.2
作者：
Heisler M;Choi H;Palmisano G;Mase R;Richardson C;Fagerlin A;Montori VM;Spencer M;An LC
通讯作者：
An LC
DOI：
10.2337/cd18-0105
发表时间：
2019-01-01
期刊：
Clinical diabetes : a publication of the American Diabetes Association
影响因子：
--
作者：
通讯作者：
--
DOI：
10.4067/s0034-98872017000500012
发表时间：
2017-05-01
期刊：
Revista médica de Chile
影响因子：
--
作者：
Serrano, Valentina;Larrea-Mantilla, Laura;Montori, Víctor M
通讯作者：
Montori, Víctor M