'Piki te Ora', a qualitative exploratory study of a primary care-led, interprofessional team for supporting patients with type 2 diabetes in rural communities.

Abstract

Introduction: Type 2 diabetes is a chronic condition predominantly managed through primary care in Aotearoa New Zealand. Primary care initiatives are being increasingly established to provide culturally safe and interprofessional care to optimise disease management.

Aim: This study aimed to qualitatively explore the 'Piki te Ora' (Ascending to Wellness) interprofessional primary care service of Te Korowai Hauora o Hauraki (a Māori general practice network) for supporting whānau (family) with type 2 diabetes.

Methods: Semi-structured interviews with patients with type 2 diabetes who were previously or currently enrolled in the Piki te Ora service between January 2021 and October 2023 were conducted between December 2023 and January 2024. Interviews were audio recorded, transcribed and thematically analysed.

Results: Nine participants were interviewed (six Māori and three NZ European; mean age 56 ± 16 years). Four overarching themes were identified: healthcare accessibility, care and support (manaakitanga), tailored holistic approach and patient empowerment. Most participants reported improved healthcare access through mobile clinics and telehealth, extended appointment times, approachable interactions with the Piki te Ora team, increased diabetes knowledge and management and a sense of empowerment from the staff. However, some participants were unaware of being enrolled in the Piki te Ora programme and found the written materials unclear, suggesting the need for clearer communication.

Discussion: The findings highlight the value of culturally safe, accessible healthcare services like Piki te Ora, particularly in addressing healthcare barriers in rural New Zealand. Further studies are needed to identify strategies for overcoming existing barriers to access and engagement, particularly in enhancing health equity for Māori.