A narrative systematic review of factors affecting diabetes prevention in primary care settings

Josie Messina, Stephen Campbell, Rebecca Morris, Emily Eyles, Caroline Sanders

Research output: Contribution to journalReview article

11 Citations (Scopus)
2 Downloads (Pure)

Abstract

Background: Type 2 diabetes is impacting millions of people globally; however, many future cases can be prevented through lifestyle changes and interventions. Primary care is an important setting for diabetes prevention, for at-risk populations, because it is a patient's primary point of contact with the health care system and professionals can provide lifestyle counselling and support, as well as monitoring health outcomes. These are all essential elements for diabetes prevention for at-risk adults. Aim: To understand the factors related to the delivery and uptake of type 2 diabetes prevention interventions within primary care in higher income countries. Methods: For this narrative systematic review, we combined qualitative and quantitative studies of diabetes prevention within a primary care setting for patients at-risk of developing the condition. We used an iterative approach for evidence collection, which included using several databases (MEDLINE, Embase, Pysch info, BNI, SSCI, CINAHL, ASSIA), where we combined diabetes terms with primary care terms. Narrative and thematic synthesis were utilised to identify the prominent themes emerging from the data. Results: A database of 6646 records was screened by the research team, and 18 papers were included. Three major themes were identified in this review. The first theme of context and setting of diabetes progression includes the risk and progression of diabetes, primary care as a setting, and where the responsibility for change is thought to lie. This review also found mixed views on the value of preventative services within primary care. The second theme focused on the various patient factors associated with diabetes prevention such as a patient's motivation to modify their current lifestyle, perceptions and knowledge (or lack thereof) of the impacts of diabetes, lack of follow-up in healthcare settings, and trust in healthcare professionals. The third theme was centred on professional factors impacting on diabetes prevention which included workload, time constraints, resources, self-efficacy and knowledge as well as professionals' perception of patient motivations towards change. Conclusion: This review explored the factors influencing diabetes prevention in primary care, and identified the context of prevention, as well as patient and professional factors related to preventative services being offered in primary care. This systematic review complements previous reviews of real-world settings by exploring the significant factors in prevention, and the findings are relevant to academics, policymakers, patients and practitioners interested in understanding the factors associated with the delivery and uptake of diabetes prevention interventions.

Original languageEnglish
Article numbere0177699
Pages (from-to)1-20
Number of pages20
JournalPLoS One
Volume12
Issue number5
DOIs
Publication statusPublished - 1 May 2017
Externally publishedYes

Fingerprint

systematic review
Medical problems
diabetes
Primary Health Care
Life Style
Delivery of Health Care
lifestyle
Type 2 Diabetes Mellitus
Motivation
Databases
noninsulin-dependent diabetes mellitus
health services
Self Efficacy
Workload
self-efficacy
MEDLINE
Counseling
patient care
counseling
at-risk population

Cite this

Messina, J., Campbell, S., Morris, R., Eyles, E., & Sanders, C. (2017). A narrative systematic review of factors affecting diabetes prevention in primary care settings. PLoS One, 12(5), 1-20. [e0177699]. https://doi.org/10.1371/journal.pone.0177699
Messina, Josie ; Campbell, Stephen ; Morris, Rebecca ; Eyles, Emily ; Sanders, Caroline. / A narrative systematic review of factors affecting diabetes prevention in primary care settings. In: PLoS One. 2017 ; Vol. 12, No. 5. pp. 1-20.
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abstract = "Background: Type 2 diabetes is impacting millions of people globally; however, many future cases can be prevented through lifestyle changes and interventions. Primary care is an important setting for diabetes prevention, for at-risk populations, because it is a patient's primary point of contact with the health care system and professionals can provide lifestyle counselling and support, as well as monitoring health outcomes. These are all essential elements for diabetes prevention for at-risk adults. Aim: To understand the factors related to the delivery and uptake of type 2 diabetes prevention interventions within primary care in higher income countries. Methods: For this narrative systematic review, we combined qualitative and quantitative studies of diabetes prevention within a primary care setting for patients at-risk of developing the condition. We used an iterative approach for evidence collection, which included using several databases (MEDLINE, Embase, Pysch info, BNI, SSCI, CINAHL, ASSIA), where we combined diabetes terms with primary care terms. Narrative and thematic synthesis were utilised to identify the prominent themes emerging from the data. Results: A database of 6646 records was screened by the research team, and 18 papers were included. Three major themes were identified in this review. The first theme of context and setting of diabetes progression includes the risk and progression of diabetes, primary care as a setting, and where the responsibility for change is thought to lie. This review also found mixed views on the value of preventative services within primary care. The second theme focused on the various patient factors associated with diabetes prevention such as a patient's motivation to modify their current lifestyle, perceptions and knowledge (or lack thereof) of the impacts of diabetes, lack of follow-up in healthcare settings, and trust in healthcare professionals. The third theme was centred on professional factors impacting on diabetes prevention which included workload, time constraints, resources, self-efficacy and knowledge as well as professionals' perception of patient motivations towards change. Conclusion: This review explored the factors influencing diabetes prevention in primary care, and identified the context of prevention, as well as patient and professional factors related to preventative services being offered in primary care. This systematic review complements previous reviews of real-world settings by exploring the significant factors in prevention, and the findings are relevant to academics, policymakers, patients and practitioners interested in understanding the factors associated with the delivery and uptake of diabetes prevention interventions.",
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Messina, J, Campbell, S, Morris, R, Eyles, E & Sanders, C 2017, 'A narrative systematic review of factors affecting diabetes prevention in primary care settings', PLoS One, vol. 12, no. 5, e0177699, pp. 1-20. https://doi.org/10.1371/journal.pone.0177699

A narrative systematic review of factors affecting diabetes prevention in primary care settings. / Messina, Josie; Campbell, Stephen; Morris, Rebecca; Eyles, Emily; Sanders, Caroline.

In: PLoS One, Vol. 12, No. 5, e0177699, 01.05.2017, p. 1-20.

Research output: Contribution to journalReview article

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T1 - A narrative systematic review of factors affecting diabetes prevention in primary care settings

AU - Messina, Josie

AU - Campbell, Stephen

AU - Morris, Rebecca

AU - Eyles, Emily

AU - Sanders, Caroline

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N2 - Background: Type 2 diabetes is impacting millions of people globally; however, many future cases can be prevented through lifestyle changes and interventions. Primary care is an important setting for diabetes prevention, for at-risk populations, because it is a patient's primary point of contact with the health care system and professionals can provide lifestyle counselling and support, as well as monitoring health outcomes. These are all essential elements for diabetes prevention for at-risk adults. Aim: To understand the factors related to the delivery and uptake of type 2 diabetes prevention interventions within primary care in higher income countries. Methods: For this narrative systematic review, we combined qualitative and quantitative studies of diabetes prevention within a primary care setting for patients at-risk of developing the condition. We used an iterative approach for evidence collection, which included using several databases (MEDLINE, Embase, Pysch info, BNI, SSCI, CINAHL, ASSIA), where we combined diabetes terms with primary care terms. Narrative and thematic synthesis were utilised to identify the prominent themes emerging from the data. Results: A database of 6646 records was screened by the research team, and 18 papers were included. Three major themes were identified in this review. The first theme of context and setting of diabetes progression includes the risk and progression of diabetes, primary care as a setting, and where the responsibility for change is thought to lie. This review also found mixed views on the value of preventative services within primary care. The second theme focused on the various patient factors associated with diabetes prevention such as a patient's motivation to modify their current lifestyle, perceptions and knowledge (or lack thereof) of the impacts of diabetes, lack of follow-up in healthcare settings, and trust in healthcare professionals. The third theme was centred on professional factors impacting on diabetes prevention which included workload, time constraints, resources, self-efficacy and knowledge as well as professionals' perception of patient motivations towards change. Conclusion: This review explored the factors influencing diabetes prevention in primary care, and identified the context of prevention, as well as patient and professional factors related to preventative services being offered in primary care. This systematic review complements previous reviews of real-world settings by exploring the significant factors in prevention, and the findings are relevant to academics, policymakers, patients and practitioners interested in understanding the factors associated with the delivery and uptake of diabetes prevention interventions.

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KW - Health Personnel/psychology

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KW - Patient Education as Topic

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KW - Qualitative Research

KW - Risk Factors

KW - Self Efficacy

KW - Workload

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