Patient’s Perspectives on Treatment Burden in Type 2 Diabetes Mellitus: Focus Groups in Primary Care Settings

Abstract

Abstract Background Understanding treatment burden is a crucial component of effectively managing Type 2 Diabetes Mellitus (T2DM). While our previous narrative review had proposed a thematic framework for identifying treatment burden in people with T2DM, the current study aimed to fill the knowledge gap about T2DM treatment burden from the patient’s perspective in primary care settings. Methods Purposive sampling was used to recruit a spread of participants from primary care settings across various socio-economic regions in China. Focus groups were organised to explore patients’ perspectives. The discussions were audio-recorded, transcribed, and analysed with a theoretical lens of the Cumulative Complexity Model (CuCoM) to facilitate the identification and understanding of patient workload and capacity in the context. Results The study engaged four focus groups, each consisting of five participants. Building on the thematic framework from previous research, this study further refined five key themes, including medical information, medication, administration, healthcare system, and lifestyle, through subtheme refinement and categorization. A significant development was the merging of the financial and time/travel themes into a new "personal resources" theme, reflecting their overlapping nature. This refinement led to a finalised conceptual framework with six core themes, including personal resources as an overlapping theme. The framework also incorporated antecedents and consequences as themes, identifying associated factors of T2DM treatment burden. Additionally, the study highlighted an often-overlooked theme of medical information in treatment burden research and underscored systemic inadequacies within the healthcare system, highlighting the critical challenge of balancing health needs with treatment accessibility in primary care settings. Conclusions This study underscores the multifaceted nature of the T2DM treatment burden. Significantly, it contributes to the development of a conceptual framework for understanding and measuring this construct in primary care settings. The study also highlights the need to consider each patient's personal resources allocation and utilisation of treatment.