“I mean, we live on an island and need to be self-sufficient, even with research” Patients' and healthcare professionals' views on participation in clinical studies in primary health care in a sparsely populated region: a qualitative study (Preprint)

Abstract

A recently published study in Finland, Norway, and Sweden found that mortality rates are higher in rural areas compared to urban regions, with this difference increasing over time. The goal is to foster a dynamic research culture in healthcare that specifically targets improving health outcomes in rural populations. This entails addressing the unique health challenges faced by these areas and increasing research efforts, which are often neglected by larger research centers. A strong research culture requires established networks, funding, technology use, and collaborative methodologies. Challenges include a lack of understanding of the factors that contribute to success and under representation of rural populations in research.

The overall aim of the study is, through focus group interviews, to get the views of patients with type 2 diabetes, physicians, and nurses on participation in clinical trials in primary care in a sparsely populated region.

Design A qualitative descriptive study conducted between the dates March 2022 to March 2023 using a semi-structured interview format for focus groups interviews. The study employed inductive qualitative content analysis to analyse transcribed audio recordings from the interviews. Setting Primary care on the island of Gotland, Sweden. Participants We consecutively invited patients with type 2 diabetes who participate in the primary care-based clinical drug trial SMARTEST and live in a rural, sparsely populated area. In this sub study, nineteen patients and, in addition, one primary care physician and two registered nurses from the local primary healthcare centre were subsequently interviewed.

The findings of this study yielded the theme: Bridging Perspectives: Engaging Patients and Professionals in Diabetes Research, with two main categories, namely "Unlocking the Potential of Rural Research – with a Spotlight on the SMARTEST Study" and "Dimensions of Engagement in Diabetes Research from the Health Professional's View." The first category encompassed five sub-categories that emerged, providing insights into the patients' viewpoints and opinions. The second category, derived from interviews conducted with healthcare professionals specialising in the field of diabetes, identified five sub-categories.

Conclusion These findings collectively underscore the significance of diabetes research in rural settings, emphasising the need for inclusive approaches that address patient perspectives, promote collaboration, and enhance research infrastructure. In addition, the results from the present study may have implications for primary care research within other chronic diseases.

(Clinicaltrials.gov identifier NCT03982381, EudraCT 2019-001046-17).