[Dissatisfaction with the DMP for CHD: An explorative survey among general practitioners on the disease management programs (DMPs) for type 2 diabetes mellitus and coronary heart disease].

Abstract

Background: Disease management programs (DMPs) were implemented in 2002 to improve the care for a growing number of chronically ill people in Germany. However, the current state of research on the effectiveness and acceptance of DMPs does not allow valid comparisons between them. The aim of the survey was to compare general practitioners' (GPs') experiences with DMPs for type 2 diabetes mellitus (T2DM) and coronary heart disease (CHD). The survey complements the results of a qualitative study conducted in 2020.

Methods: Cross-sectional exploratory study using an online survey among GPs in the area of the North Rhine Association of Statutory Health Insurance Physicians in 2023. In addition to general questions on DMPs, the DMPs for T2DM and CHD were compared in regard to three main topics: (1) perceived effectiveness of DMPs, (2) satisfaction with DMPs, and (3) perceived self-management of patients in the DMPs. A total of 42 items were used.

Results: The survey was completed by 186 GPs, resulting in a response rate of 10.4%. 96% were practice owners, all of whom had experience in implementing these DMPs. Significant differences were observed in the perceived effectiveness of the two DMPs, e.g. in reducing complications and hospitalizations, with consistently lower ratings for the DMP for CHD. This was also evident in the thematic blocks on satisfaction with DMPs, with regard to enrolment patterns and documentation, as well as patients' self-management in terms of health behaviour and personal responsibility.

Conclusion: Future studies should examine DMPs in GP care separately, given the significant differences in how they are evaluated by GPs. In addition, DMPs should be analysed in more detail regarding effectiveness, feasibility, and acceptance, especially the DMP for CHD.