Syed Muslim Abbas, Zainel Abduljaleel Abdullatif, Alnuaimi Ahmed Sameer, Veettil Shajitha Thekke, Syed Mohamed Ahmed
Clinical Research Department, Primary Health Care Corporation, Doha, Qatar.
BMJ Public Health. 2025 Apr 9;3(1):e001969. doi: 10.1136/bmjph-2024-001969. eCollection 2025.
Globally, diabetes constitutes a major proportion of non-communicable diseases. Qatar has one of the highest prevalences of diabetes worldwide and a high proportion of people visiting non-communicable disease clinics in primary care settings have diabetes. A significant percentage of people with diabetes in Qatar have glycosylated haemoglobin (HbA1c) levels outside the target range. The aim of this study is to explore the perspectives of people with diabetes, whose HbA1c is above target range, and healthcare providers (HCPs) who are directly involved in the management of care of their disease condition within primary care settings. The key objectives of the study include highlighting the key components of service delivery mechanisms and expectations of both service care providers and people living with diabetes to identify the existing gaps and generate recommendations for improving the quality of services.
The study design was qualitative research. A focus group discussion was conducted among HCPs (n=23) mainly comprising family medicine physicians, ophthalmologists, dieticians, nurses, health educators and pharmacists who are directly involved in supporting (caring for) people with diabetes to manage their condition and currently working in primary health centres in the state of Qatar. People with diabetes and an HbA1c greater than 7% over the previous 6 months were recruited to participate in telephone interviews by non-probability convenience sampling. The results of the study are reported in accordance with the Consolidated Criteria for Reporting Qualitative Research and the Standards for Reporting Qualitative Research guidelines.
The main themes that emerged from the interviews with people with diabetes included (1) desirable attributes of physician, (2) medication, (3) privacy and confidentiality, (4) exclusive services and (5) recommendations to improve the services. Among the key recommendations to improve the existing services, the HCPs emphasised the need to introduce an integrated model of care composed of a multidisciplinary team of HCPs mainly prioritising and targeting high-risk patients. The integration of medical and social models of care as well as innovative interventions such as introducing social support groups, peer support, strengthening health literacy channels, artificial intelligence-powered applications and life coaches to support people with diabetes and elevated HbA1c to improve self-management were also suggested by HCPs.
Strengthening health literacy and communication channels, implementing an integrated model of care, and testing innovative interventions (such as social support groups, artificial intelligence-powered applications and life coaches) by conducting high-quality research can improve the existing healthcare services for management of diabetes. These proposed strategies can improve self-care and timely administration of medication, help achieve desired health outcomes, reduce the burden of disease and associated costs to the healthcare system and further substantiate evidence-based patient-centred care.
在全球范围内，糖尿病在非传染性疾病中占很大比例。卡塔尔是全球糖尿病患病率最高的国家之一，在初级保健机构就诊的非传染性疾病患者中有很大一部分患有糖尿病。卡塔尔相当一部分糖尿病患者的糖化血红蛋白（HbA1c）水平超出目标范围。本研究旨在探讨HbA1c高于目标范围的糖尿病患者以及在初级保健机构直接参与其疾病护理管理的医疗服务提供者（HCPs）的观点。该研究的主要目标包括突出服务提供机制的关键组成部分以及服务提供者和糖尿病患者的期望，以识别现有差距并提出改善服务质量的建议。
本研究设计为定性研究。对主要由家庭医学医生、眼科医生、营养师、护士、健康教育工作者和药剂师组成的23名HCPs进行了焦点小组讨论，他们直接参与支持（护理）糖尿病患者管理病情，目前在卡塔尔国的初级保健中心工作。通过非概率便利抽样，招募过去6个月HbA1c大于7%的糖尿病患者参与电话访谈。本研究结果按照《定性研究报告综合标准》和《定性研究报告标准指南》进行报告。
对糖尿病患者访谈中出现的主要主题包括：（1）医生的理想特质；（2）药物治疗；（3）隐私与保密；（4）专属服务；（5）改善服务的建议。在改善现有服务的关键建议中，HCPs强调需要引入一种由多学科HCPs团队组成的综合护理模式，主要针对高危患者并将其作为优先事项。HCPs还建议将医疗和社会护理模式相结合，以及采用创新干预措施，如引入社会支持小组、同伴支持、加强健康素养渠道、人工智能驱动的应用程序和生活教练，以支持糖尿病患者和HbA1c升高的患者改善自我管理。
通过开展高质量研究，加强健康素养和沟通渠道、实施综合护理模式以及测试创新干预措施（如社会支持小组、人工智能驱动的应用程序和生活教练），可以改善现有的糖尿病医疗服务。这些提议的策略可以改善自我护理和药物的及时使用，有助于实现理想的健康结果，减轻疾病负担和医疗系统的相关成本，并进一步证实以患者为中心的循证护理。
