Personalised Care-and-Support-Planning in Singapore: Qualitative interviews with people living with diabetes

Abstract

BackgroundPersonalised care-and-support-planning (CSP) is a person-centred approach for the care of persons living with long-term conditions. PACE-D or Patient Activation through Community Empowerment/ Engagement for Diabetes Management adapts the Year of Care Partnerships (YOCP) approach to CSP in the UK for persons living with diabetes at the Singapore polyclinic; multi-storey primary care hubs that provide affordable, multidisciplinary, comprehensive, and high-throughput public healthcare for the multi-ethnic, multi-lingual Singapore population.AimTo explore the experience of PACE-D enrolled persons living with diabetes with personalised CSP at Singapore polyclinics.Design & settingQualitative interviews of persons living with diabetes who experienced personalised CSP at National University Polyclinics (NUP) between July 2020 and November 2021.MethodPACE-D enrolled persons living with diabetes who experienced personalised CSP were purposively sampled. In-depth semi-structured interviews were recorded, transcribed, and analysed using Braun & Clarke’s reflexive thematic analysis.Results52 patients participated in the study. Patients reported that the care-planning-letter (CPL) prompted reflection and patient preparation for CSP conversations. PACE-D programme coordinators amplified self-management by playing advocate and confidant beyond administrative duties. CSP providers were perceived as partners-in-care, with more time to listen compared to usual consultations. Patient engagement was affected by language confidence. With adequate time and support, patients increased in confidence and agency both in CSP engagement and diabetes self-management.ConclusionWhile language confidence may affect patient engagement, personalised CSP shows promise for strengthening patient engagement and self-management among persons living with diabetes at the Singapore polyclinic.