Implementation of a Structured Diabetes Consultation Model to Facilitate a Person-Centered Approach:Results From a Nationwide Dutch Study

OBJECTIVE: We assessed both from a patient and provider perspective the usefulness and added value of a consultation model that facilitates person-centered diabetes care. RESEARCH DESIGN AND METHODS: The model consists of 1) inventory of disease and patient-related factors; 2) setting personal goals; 3) choosing treatment; and 4) determination of required care. It was implemented in 47 general practices and 6 hospital outpatient clinics. Providers were trained, and patients were recommended to prepare their visit. All filled out a questionnaire after every consultation. Differences between pri... Mehr ...

Verfasser: Rutten, Guy E H M
van Vugt, Heidi A
de Weerdt, Inge
de Koning, Eelco
Dokumenttyp: Artikel
Erscheinungsdatum: 2018
Reihe/Periodikum: Rutten , G E H M , van Vugt , H A , de Weerdt , I & de Koning , E 2018 , ' Implementation of a Structured Diabetes Consultation Model to Facilitate a Person-Centered Approach : Results From a Nationwide Dutch Study ' , Diabetes Care , vol. 41 , no. 4 , pp. 688-695 . https://doi.org/10.2337/dc17-1194
Schlagwörter: Aged / Ambulatory Care Facilities / Decision Making / Decision Support Techniques / Diabetes Mellitus / Type 2/diagnosis / Female / Health Plan Implementation / Humans / Male / Middle Aged / Netherlands / Patient Participation / Patient-Centered Care/methods / Physicians / Referral and Consultation/organization & administration / Surveys and Questionnaires
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-27588660
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://pure.knaw.nl/portal/en/publications/2415178d-ddcc-449d-8aa0-80625fbb22c3

OBJECTIVE: We assessed both from a patient and provider perspective the usefulness and added value of a consultation model that facilitates person-centered diabetes care. RESEARCH DESIGN AND METHODS: The model consists of 1) inventory of disease and patient-related factors; 2) setting personal goals; 3) choosing treatment; and 4) determination of required care. It was implemented in 47 general practices and 6 hospital outpatient clinics. Providers were trained, and patients were recommended to prepare their visit. All filled out a questionnaire after every consultation. Differences between primary and secondary care practices and between physician-led and nurse-led consultations were analyzed. RESULTS: Seventy-four physicians and thirty-one nurses participated, reporting on 1,366 consultations with type 2 diabetes patients. According to providers, the model was applicable in 72.4% (nurses 79.3% vs. physicians 68.5%, P < 0.001). Physicians more often had a consultation time <25 min (80.4% vs. 56.9%, P < 0.001). According to providers, two of three patients spoke more than half of the consultation time (outpatient clinics 75.2% vs. general practices 66.6%, P = 0.002; nurses 73.2% vs. physicians 64.4%, P = 0.001). Providers stated that person-related factors often determined treatment goals. Almost all patients (94.4%) reported that they made shared decisions; they felt more involved than before (with physicians 45.1% vs. with nurses 33.6%, P < 0.001) and rated the consultation 8.6 of 10. After physician-led consultations, 52.5% reported that the consultation was better than before (nurse visit 33.7%, P < 0.001). CONCLUSIONS: A consultation model to facilitate person-centered care seems well applicable and results in more patient involvement, including shared decision making, and is appreciated by a substantial number of patients.