General practitioner and nurse experiences of type 2 diabetes management and prescribing in primary care: a qualitative review following the introduction of funded SGLT2i/GLP1RA medications in Aotearoa New Zealand

被引：0

作者：

Norman, Kimberley ^{[1
]}

Mustafa, Sara Tareq ^{[2
]}

Cassim, Shemana ^{[3
]}

Mullins, Hilde ^{[4
]}

Clark, Penny ^{[5
]}

Keenan, Rawiri ^{[2
]}

Te Karu, Leanne ^{[6
]}

Murphy, Rinki ^{[6
]}

Paul, Ryan ^{[2
,7
]}

Kenealy, Tim ^{[6
]}

Chepulis, Lynne ^{[2
]}

机构：

[1] Monash Univ, Sch Primary & Allied Hlth Care, Melbourne, Australia

[2] Univ Waikato, Med Res Ctr, TeHuataki Waiora Sch Hlth, Hamilton, New Zealand

[3] Massey Univ, Sch Psychol, Auckland, New Zealand

[4] Univ Waikato, Huataki Waiora Sch Hlth, Dept Nursing, Hamilton, Bermuda

[5] Northcare Med Ctr, Hamilton, New Zealand

[6] Univ Auckland, Fac Med & Hlth Sci, Auckland, New Zealand

[7] Whatu Ora Hlth New Zealand, Auckland, New Zealand

来源：

PRIMARY HEALTH CARE RESEARCH & DEVELOPMENT | 2024年 / 25卷

关键词：

medication; primary health care; qualitative research; type; 2; diabetes; PACIFIC PEOPLES; BARRIERS; MAORI;

D O I：

10.1017/S1463423624000264

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Aim: To explore the views of general practitioners (GPs) and nurses on type 2 diabetes (T2D) management, including the use of recently funded T2D medications in New Zealand (NZ) and their perceived barriers to providing optimal care.Background: T2D is a significant health concern in NZ, particularly among M & amacr;ori and Pacific adults. Characterised by prolonged hyperglycaemia, T2D is generally a progressive condition requiring long-term care.Methods: Semi-structured interviews were conducted between July and December 2022 with 21 primary care clinicians (10 GPs and 11 nurses/nurse prescribers) from nine different general practice clinics across the Auckland and Waikato regions of NZ. Framework analysis was conducted to identify common themes in clinicians' perceptions and experiences with T2D management.Findings: Three themes were identified: health-system factors, new medications, and solution-based approaches. Lack of clinician time, healthcare funding, staff shortages, and burn-out were identified as barriers to T2D management under health-system factors. The two newly funded medications, empagliflozin and dulaglutide, were deemed to be a positive change for T2D care in that they improved patient satisfaction and clinical outcomes, but several clinicians were hesitant to prescribe these medications. Participants suggested that additional education and specialist diabetes support would be helpful to inform optimal medication prescribing and that better use of a multi-disciplinary team (clinical and support staff) could support T2D care by reducing workload, addressing cultural gaps in healthcare delivery, and reducing burnout. An improved primary care work environment, including appropriate professional development to support prescribing of new medications and the value of collaboration with a non-regulated workforce, may be required to facilitate optimal T2D management in primary care. Future research should focus on interventions to increase support for both clinical teams and patients while adopting a culturally appropriate approach to increase patient satisfaction and improve health outcomes.

引用

页数：7