Patient perspectives of the operationalization of adult patient-centered care at the Primary Care Diabetes Support Program, London, Ontario: A Qualitative Descriptive Study.

Abstract

Background: Patient-centered care is a hallmark of family medicine, and patient-centered care for diabetes has been associated with better outcomes. The Primary Care Diabetes Support Program (PCDSP) in London, Ontario, uses a patient-centered model of care and targets three groups of patients at high risk for diabetes complications: 1) medically complex, 2) socially complex, and 3) those without a primary care provider. We describe, from the patient's perspectives, how the PCDSP operationalizes patient-centered care.

Approach: Using maximum variation sampling, we recruited and interviewed 17 patients regarding their experiences with the PCDSP. We asked patients about the PCDSP's approach to care and its impact on their diabetes management and overall health. We coded interview transcripts using an inductive thematic analysis approach.

Results: We identified eight attributes of PCDSP care that aligned with the principles of patient-centered of care: 1) reassurance, 2) education, 3) whole person care, 4) individualized care, 5) high accessibility, 6) co-ordinated care, 7) integration of new technologies, and 8) ownership of care. Participants emphasized that they felt the care they received from the PCDSP was tailored to their individual needs, accessible, coordinated care with other providers, and gave them access to new medications and technologies as well as the latest research on diabetes care.

Conclusions: Findings highlight that the PCDSP approach is more holistic than existing patient-centered care models for diabetes described in the literature, which focus on education and skills to improve self-management. The attributes identified are mutually reinforcing, and our findings reflect longitudinal, high-quality primary care approach through the PCDSP.