How general practitioners and patients discuss type 2 diabetes mellitus and cardiovascular diseases concerns during consultations: Implications for digital health

Author:

Rohilla Urvashi1ORCID,Ramarao Jayashanthi P2,Lane Jared1,Khatri Neha N1,Smith James3,Yin Kathleen1,Lau Annie YS1

Affiliation:

1. Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia

2. Liverpool Hospital, South Western Sydney Local Health District, Liverpool, New South Wales, Australia

3. Centre for Precision Health, Collaborative Genomics and Translation Group, Edith Cowan University, Perth, WA, Australia

Abstract

Objective To analyse general practitioner–patient consultations about type 2 diabetes mellitus or cardiovascular diseases and describe (i) the nature of self-management discussions; (ii) actions required from patients during and after consultation regarding self-management; and (iii) implications for digital health to support patients during (and after) consultation. Method This study screened 281 general practitioner consultations conducted in 2017 within the UK general practice setting from an existing dataset containing videos and transcripts of consultations between GPs and patients. Secondary analysis was conducted using a multi-method approach, including descriptive, content, and visualisation analysis, to inform the nature of self-management discussions, what actions are required from patients, and whether digital technology was mentioned during the consultation to support self-management. Results Analysis of eligible 19 consultations revealed a discord between what self-management actions are required of patients during and after consultations. Lifestyle discussions are often discussed in depth, but these discussions rely heavily on subjective inquiry and recall. Some patients in these cohorts are overwhelmed by self-management, to the detriment of their personal health. Digital support for self-management was not a major topic of discussion, however, we identified a number of emergent gaps where digital technology can support self-management concerns. Conclusion There is potential for digital technology to reconcile what actions are required of patients during and after consultations. Furthermore, a number of emergent themes around self-management have implications for digitalisation.

Funder

National Health and Medical Research Council

Publisher

SAGE Publications

Subject

Health Information Management,Computer Science Applications,Health Informatics,Health Policy

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