School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia.
School of Health Sciences, Western Sydney University, Campbelltown, New South Wales, Australia.
Diabet Med. 2024 Jun;41(6):e15301. doi: 10.1111/dme.15301. Epub 2024 Feb 4.
The UK Diabetes Remission Clinical Trial (DiRECT) study was replicated in an Australian primary care setting. This qualitative study aimed to explore and understand the perceptions and experiences of both participants and healthcare professionals (HCPs) involved in the DiRECT-Australia Type 2 Diabetes Remission Service.
All participants and HCPs delivering the service were invited to participate in semi-structured interviews via online videoconferencing. The interview guides explored perceptions and experiences in DiRECT-Australia, covering aspects such as barriers and facilitators to recruitment and participation, motivations and challenges across service phases, adequacy of support provided and the overall acceptability of the service. All interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis.
Eight DiRECT-Australia participants and six HCPs (three general practitioners, two practice nurses and one dietitian) participated. Four overarching themes were identified: (1) Enablers and barriers to recruitment and continuous participation in DiRECT-Australia; (2) Motivators and overcoming barriers across the total diet replacement, food reintroduction and weight maintenance phases; (3) Importance of participant-HCP interactions and continuous support; (4) Acceptance and long-term need for DiRECT-Australia. Adherence to total diet replacement was less challenging than anticipated by participants. Transitioning to the food reintroduction phase was difficult but overcome through HCP support. DiRECT-Australia was well accepted by both participants and HCPs, and participants expressed willingness to continue with the service, if provided on a long-term basis.
Both participants and HCPs were highly interested in the new diabetes remission service set up in an Australian primary care setting. The acceptability of DiRECT-Australia was underscored by participants emphasising the effectiveness of the service in achieving significant weight loss and diabetes remission. There is a need for long-term and wider implementation of the service to ensure that anyone with recent onset type 2 diabetes is offered the best possible chance to achieve remission.
英国糖尿病缓解临床试验（DiRECT）在澳大利亚基层医疗环境中得到了复制。这项定性研究旨在探索和了解参与 DiRECT-澳大利亚 2 型糖尿病缓解服务的参与者和医疗保健专业人员（HCP）的看法和经验。
所有参与和提供服务的 HCP 都被邀请通过在线视频会议进行半结构化访谈。访谈指南探讨了 DiRECT-Australia 的看法和经验，涵盖了招募和参与的障碍和促进因素、服务各阶段的动机和挑战、提供的支持是否充分以及服务的整体可接受性等方面。所有访谈均进行了录音、逐字转录，并使用主题分析进行了分析。
有 8 名 DiRECT-Australia 参与者和 6 名 HCP（3 名全科医生、2 名执业护士和 1 名营养师）参与了研究。确定了四个总体主题：（1）DiRECT-Australia 招募和持续参与的促进因素和障碍；（2）整个饮食替代、食物再引入和体重维持阶段的动机和克服障碍；（3）参与者-HCP 互动和持续支持的重要性；（4）对 DiRECT-Australia 的接受和长期需求。参与者对完全饮食替代的依从性比预期的要低。过渡到食物再引入阶段很困难，但通过 HCP 的支持得以克服。DiRECT-Australia 得到了参与者和 HCP 的高度认可，参与者表示如果长期提供该服务，他们愿意继续接受该服务。
参与者和 HCP 都对澳大利亚基层医疗环境中设立的新糖尿病缓解服务非常感兴趣。参与者强调该服务在实现显著体重减轻和糖尿病缓解方面的有效性，突出了 DiRECT-Australia 的可接受性。需要长期和更广泛地实施该服务，以确保为近期确诊的 2 型糖尿病患者提供尽可能好的缓解机会。
