Dataset Information

How point-of-care HbA_1c testing changes the behaviour of people with diabetes and clinicians - a qualitative study.

ABSTRACT:

Aim

To explore adults with diabetes and clinician views of point-of-care HbA_1c testing.

Methods

Adults with diabetes and HbA_1c ≥ 58 mmol/mol (7.5%) receiving HbA_1c point-of-care testing in primary care were invited to individual interviews. Participants were interviewed twice, once prior to point-of-care testing and once after 6 months follow-up. Clinicians were interviewed once. A thematic framework based on an a priori framework was used to analyse the data.

Results

Fifteen participants (eight women, age range 30-70 years, two Asians, 13 white Europeans) were interviewed. They liked point-of-care testing and found the single appointment more convenient than usual care. Receiving the test result at the appointment helped some people understand how some lifestyle behaviours affected their control of diabetes and motivated them to change behaviours. Receiving an immediate test result reduced the anxiety some people experience when waiting for a result. People thought there was little value in using point-of-care testing for their annual review. Clinicians liked the point-of-care testing but expressed concerns about costs.

Conclusions

This work suggests that several features of point-of-care testing may encourage behavioural change. It helped some people to link their HbA_1c result to recent lifestyle behaviours, thereby motivating behavioural change and reinforcing healthy lifestyle choices.

SUBMITTER: Hirst JA

PROVIDER: S-EPMC7318570 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Publications

How point-of-care HbA<sub>1c</sub> testing changes the behaviour of people with diabetes and clinicians - a qualitative study.

Hirst J A JA Farmer A J AJ Williams V V

Diabetic medicine : a journal of the British Diabetic Association 20200108 6

<h4>Aim</h4>To explore adults with diabetes and clinician views of point-of-care HbA<sub>1c</sub> testing.<h4>Methods</h4>Adults with diabetes and HbA<sub>1c</sub> ≥ 58 mmol/mol (7.5%) receiving HbA<sub>1c</sub> point-of-care testing in primary care were invited to individual interviews. Participants were interviewed twice, once prior to point-of-care testing and once after 6 months follow-up. Clinicians were interviewed once. A thematic framework based on an a priori framework was used to analy ...[more]

PMID: 31876039

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Project description:IntroductionObesity is associated with compromised glucose metabolism. Hence, it is of interest to investigate if the lifestyle interventions used in the LIBRA-cohort, which aimed at not only weight loss, but also patient well-being, could also help obese patients improve glucose metabolism by evidence of reduced HbA1c. The aim of the study was to retrospectively investigate if patients who were referred to a lifestyle intervention for obesity, were able to alter HbA1c.Research design and methodsPatients with a BMI≥30 undergoing a 6-month lifestyle intervention, who also completed physical and mental health surveys and whose baseline and 6-month blood samples were available, were included in the analysis. For changes in HbA1c and body weight a clinically relevant change of 5≥mmom/mol and 5%≥, respectively, was chosen. Participants were divided into groups according to their baseline HbA1c level: "Diabetes": HbA1c of ≥6.5% (≥48 mmol/mol), "Prediabetes": HbA1c of 5.7% to 6.4% (39-47.99 mmol/mol) or "Normal" HbA1c <5.7% (<39 mmol/mol).Results180 patients met the stated inclusion criteria and these patients were divided into groups (median age (25th;75th quartile): Diabetes: n=47, age 54 (43;60), 51% women, Prediabetes: n=68, age 60 (50;66), 71% women and Normal: n=65, median age 61 (50;66), 85% women. Significant reductions were found in all three groups and specifically in the diabetes group HbA1c was reduced (mean [95%CI]) -5[-8;-2] mmol/mol from baseline to the end of the intervention. Furthermore, 35% of patients with prediabetes normalized their HbA1c (<39) and 30% patients with diabetes reduced their HbA1c <48. All groups had clinically relevant (≥5%) reductions in body weight (p<0.01). There was an association between body weight reduction and HbA1c reduction in the diabetes group (p<0.01). All groups reported improvements in physical health (p<0.01).ConclusionIn this retrospective cohort study, all patients achieved clinically relevant weight loss after participation in the lifestyle intervention and obese patients with diabetes achieved clinically relevant reductions in HbA1c after 6-months. More than 1/3 of patients with prediabetes normalized their HbA1c.

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Dataset Information

How point-of-care HbA_1c testing changes the behaviour of people with diabetes and clinicians - a qualitative study.

Aim

Methods

Results

Conclusions

Publications

How point-of-care HbA<sub>1c</sub> testing changes the behaviour of people with diabetes and clinicians - a qualitative study.

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OmicsDI is part of the ELIXIR infrastructure

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Dataset Information

How point-of-care HbA1c testing changes the behaviour of people with diabetes and clinicians - a qualitative study.

Aim

Methods

Results

Conclusions

Publications

How point-of-care HbA&lt;sub&gt;1c&lt;/sub&gt; testing changes the behaviour of people with diabetes and clinicians - a qualitative study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

How point-of-care HbA_1c testing changes the behaviour of people with diabetes and clinicians - a qualitative study.

How point-of-care HbA<sub>1c</sub> testing changes the behaviour of people with diabetes and clinicians - a qualitative study.