Scandinavian Journal of Primary Health Care最新文献

{"title":"Effects on HbA1c of referral of type 2 diabetes patients to secondary care.","authors":"Kjersti Nøkleby, Anne K Jenum, Esben Selmer Buhl, Tor Claudi, John G Cooper, Signe Flottorp, Karianne F Løvaas, Sverre Sandberg, Tore Julsrud Berg","doi":"10.1080/02813432.2024.2433107","DOIUrl":"https://doi.org/10.1080/02813432.2024.2433107","url":null,"abstract":"<p><strong>Aim: </strong>To study trajectories of HbA1c in type 2 diabetes (T2D) patients referred to diabetes outpatient clinics (DOCs), and to explore characteristics of referrals and patient pathways in patients treated in DOCs.</p><p><strong>Methods: </strong>We retrospectively followed T2D patients from the Norwegian population-based ROSA 4 study to identify persons with T2D who were referred to a DOC. We used latent class trajectory modelling to identify subgroups of patients with similar patterns of HbA1c one year before to one year after the first consultation at a DOC. We performed multinomial regression analyses to identify baseline characteristics associated with group membership.</p><p><strong>Results: </strong>Four hundred and two of 6716 T2D patients started treatment at a DOC, constituting a yearly starting rate of 1.5%. We identified three classes of HbA1c trajectories: (1) stable moderate hyperglycaemia (75%); (2) severe hyperglycaemia with a decline in HbA1c around referral (14%) and (3) severe hyperglycaemia with a decline in HbA1c after starting treatment at the DOC (11%). HbA1c trajectories were associated with diabetes duration RRR 0.92, CI (0.87, 0.97) in class 2 vs. 1 and 0.93 (0.88, 0.98) in class 3 vs. 1. Some differences were found between clinics in rejection rate, processes of care, and duration of follow-up.</p><p><strong>Conclusions: </strong>Norwegian GPs handle most T2D patients themselves. Those with T2D and severe hyperglycaemia had a considerable benefit from being referred to a DOC, though with two separate trajectories: One where HbA1c improved around the time of referral, and another that improved after starting in a DOC.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"1-11"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To neutrally offer or strongly recommend? General practitioners' perspectives on screening for gestational diabetes according to the national guideline in Norway.","authors":"Ingeborg Forthun, Kathy Ainul Møen, Stefán Hjörleifsson","doi":"10.1080/02813432.2024.2378204","DOIUrl":"10.1080/02813432.2024.2378204","url":null,"abstract":"<p><strong>Objective: </strong>To explore general practitioners' experiences and reflections on how the current Norwegian guideline for screening for gestational diabetes affects their clinical practice.</p><p><strong>Design: </strong>A qualitive study in which data were collected through semi-structured focus group interviews and analyzed thematically.</p><p><strong>Setting and subjects: </strong>Five focus groups conducted in 2020 among GPs in Norway; three interviews took place face-to-face and two were held digitally. The total number of participants was 31.</p><p><strong>Results: </strong>GPs acknowledged the potential benefits of more extensive screening, but had concerns about the medicalization of pregnancy, stating that some women experienced considerable anxiety. The GPs expressed doubts about the guideline's evidence base but differed in how they interpreted what the guideline was asking them to do. Some offered eligible women the opportunity to be screened, while other set up a screening appointment without consulting the women first. For some, fear of incrimination made them recommend screening without being convinced that it was the right thing for the patient.</p><p><strong>Conclusions: </strong>It is unclear whether the guideline for gestational diabetes requires GPs to recommend screening to pregnant women or if they should provide neutral information about the availability of screening. This ambiguity should be addressed, and the guideline evaluated against the core principles of general practice.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"668-676"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physicians' intentions to use digital tools - a comparative survey, before and after the COVID-19 pandemic, in Southern Sweden.","authors":"Sofia Olofsson, Fredric Karlsson, Miriam Pikkemaat, Björn Ekman, Mattias Rööst, Hans Thulesius, Veronica Milos Nymberg","doi":"10.1080/02813432.2024.2346133","DOIUrl":"10.1080/02813432.2024.2346133","url":null,"abstract":"<p><strong>Objectives: </strong>To describe changes in Swedish primary care physicians' use of, attitudes and intentions toward digital tools in patient care between 2019 and 2022.</p><p><strong>Design: </strong>A survey using a validated questionnaire measuring physician's intentions to use digital tools based on the theory of planned behavior.</p><p><strong>Setting: </strong>Sample of primary health care centers in southern Sweden.</p><p><strong>Subjects: </strong>Primary care physicians.</p><p><strong>Main outcome measures: </strong>Self-reported use and intentions to use, digital tools including digital consultations by text or video, chronic disease monitoring and artificial intelligence (AI) and the associations between attitudes, subjective norms, perceived behavioral control and behavioral intentions to use digital tools, in 2019 compared to 2022.</p><p><strong>Results: </strong>In both 2019 (<i>n</i> = 198) and 2022 (<i>n</i> = 93), physicians reported high intentions to use digital tools. Self-reported use of video was slightly higher in 2022 (<i>p</i> = .03). No other changes were seen in the self-reported use or behavioral intentions to use digital tools.</p><p><strong>Conclusion: </strong>The slow adoption of patient-related digital tools in Swedish primary health care does not seem to be explained by a low intention to use them among physicians. Future research on implementation of digital tools should include a focus on contextual factors such as organizational, technical and cultural barriers.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"497-514"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reflections of nurses and primary healthcare managers on integrating hospital at home into public primary healthcare services: a Norwegian focus group study.","authors":"Lillian Karlsen, Bente Prytz Mjølstad, Bjarte Bye Løfaldli, Anne-Sofie Helvik","doi":"10.1080/02813432.2024.2373310","DOIUrl":"10.1080/02813432.2024.2373310","url":null,"abstract":"<p><strong>Background: </strong>Hospital at home (HaH) is an innovative approach to healthcare delivery that brings specialized services to patients' homes. HaH services are typically available in urban areas where hospitals can easily reach nearby patients. An integrated care model that utilizes the public primary healthcare system may extend HaH services to include patients residing further away from hospitals. However, there is limited evidence of primary healthcare employees' views on integrating HaH care into primary healthcare services. This study aimed to explore the reflections of primary healthcare employees on integrating HaH care into primary healthcare services.</p><p><strong>Methods: </strong>Ten focus group interviews were conducted with homecare nurses and managers of primary healthcare services in five municipalities in Mid-Norway. Reflexive thematic analysis was used to analyze the data.</p><p><strong>Results: </strong>The analysis resulted in three key themes regarding the integration of HaH care into primary healthcare. Participants discussed how they capture the distinctiveness of HaH care within the primary healthcare landscape. Moreover, they identified that the introduction of HaH care reveals opportunities to address challenges. Lastly, the study uncovered a strong primary healthcare commitment and a sense of professional pride among the participants. This resilience and dedication among primary healthcare employees appeared as an incentive to make the integration of HaH work.</p><p><strong>Conclusions: </strong>This study offers valuable insights into integrating HaH into primary healthcare services, highlighting opportunities to address challenges. The resilience and dedication of primary healthcare employees underscore their commitment to adapting to and thriving with HaH care. To establish a sustainable HaH care model, it is important to address geographical limitations, consider the strain on providers, maintain robust relationships, enhance funding, and formalize decision-making processes.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"633-642"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gatekeeping and referral of patients holding private health insurance: a survey among general practitioners in Norway.","authors":"Jørgen Breivold, Karin Isaksson Rø, Stein Nilsen, Merethe Kristine Kousgaard Andersen, Jørgen Nexøe, Stefán Hjörleifsson","doi":"10.1080/02813432.2024.2380923","DOIUrl":"10.1080/02813432.2024.2380923","url":null,"abstract":"<p><strong>Objective: </strong>Private health insurance is becoming more common in Norway. The aim of this study was to investigate GPs' opinions on private health insurance, and their experiences from consultations where health insurance can affect decisions about referring.</p><p><strong>Design: </strong>A web based cross-sectional survey.</p><p><strong>Setting: </strong>Norwegian general practice.</p><p><strong>Subjects: </strong>All GPs in Norway were in 2019 invited to participate in an online survey.</p><p><strong>Main outcome measures: </strong>The GPs' opinions and experiences regarding health insurance were reported as proportions. Multiple logistic regression was used to test associations between how frequently GPs refer patients without further considerations and variables concerning their characteristics, opinions, and experiences.</p><p><strong>Results: </strong>Of 1,309 GPs (response rate 27%), 93% stated that private health insurance raises the risk of overtreatment and 90% considered such insurance to contribute to inequality in health. Frequently being pressured to refer in the absence of a medical indication was reported by 42%. Moreover, 28% often or always chose to refer patients without further consideration, and this was associated with perceptions of pressure with an adjusted odds ratio (AOR) of 3.80, 95% confidence interval (CI) 2.73-5.29, and unpleasant reactions from patients following refusals (AOR 1.63, 95% CI 1.14-2.33).</p><p><strong>Conclusion: </strong>Although most participating GPs associated private health insurance with overtreatment and inequality in health, more than one in four choose to refer without further consideration. GPs' experience of pressure to refer and negative reactions from patients when they consider referrals not to be medically indicated, raises the risk of medical overuse for patients holding private health insurance.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"695-703"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of the digital gp visits and characteristics of the users: retrospective observational study.","authors":"Sanna Lakoma, Henna Pasanen, Kaisla Lahdensuo, Jaakko Pehkonen, Jutta Viinikainen, Paulus Torkki","doi":"10.1080/02813432.2024.2380921","DOIUrl":"10.1080/02813432.2024.2380921","url":null,"abstract":"<p><strong>Objectives: </strong>This study compares the demographics, diagnoses, re-admission rates, sick leaves, and prescribed medications of patients accessing digital general practitioner (GP) visits with those of patients opting for traditional face-to-face appointments in a primary health care setting.</p><p><strong>Design: </strong>The study adopted a retrospective analysis of patient record data collected in 2019, comparing visits to a digital primary health center with traditional health center visits.</p><p><strong>Setting: </strong>Primary health care.</p><p><strong>Participants: </strong>The data encompassed patients who utilized the digital clinic and those who visited public health centers for primary health care services.</p><p><strong>Main outcome measures: </strong>The study assessed demographics, health diagnoses, prescribed medications, sick leave recommendations, re-admission rates, and differences in costs between digital clinic and face-to-face visits. Secondary outcomes included a comparative analysis of medication categories, resolution rates for health problems, and potential impacts on health care utilization.</p><p><strong>Results: </strong>Digital clinic users were typically younger, more educated, and predominantly female compared with health centre users. Digital visits were well-suited for uncomplicated infections, while health centre appointments were associated with a higher prevalence of chronic conditions. Medication patterns differed between the two modalities, with digital clinic users receiving generic over-the-counter drugs and antibiotics, whereas health centre visits commonly involved cardiac and antihypertensive medications. Sick leave recommendations were slightly higher in the digital clinic, but the difference was not significant. Approximately 70% of health problems addressed in the digital clinic were successfully resolved, and the cost of digital visits was about 50,3% of face-to-face appointments.</p><p><strong>Conclusion: </strong>Digital health care services offer a cost-efficient alternative for specific health problems, appealing to younger, educated individuals, when compared to the users of public health center, and may enable improvement of cost-effectiveness combined with acceptable demand management and patient segmentation practices. The results highlight the potential benefits of digital clinics, particularly for uncomplicated cases, while also emphasizing the importance of suitable referral mechanisms for in-person consultations.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"686-694"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in analgesic prescriptions in Dutch general practice.","authors":"D Veldkamp, N Pooters, H J Schers, R Akkermans, T C Olde Hartman, A A Uijen","doi":"10.1080/02813432.2024.2387423","DOIUrl":"10.1080/02813432.2024.2387423","url":null,"abstract":"<p><strong>Background: </strong>Increases in opioid prescriptions have been described; however, recent trends and prescribing patterns of analgesics in Dutch general practice are largely unknown.</p><p><strong>Objective: </strong>To investigate recent changes in the number of analgesic prescriptions, and the indications for prescribing strong opioids. Furthermore, we aim to identify risk factors for chronic opioid use in Dutch general practice.</p><p><strong>Design and setting: </strong>A retrospective cohort study from 1 July 2013 to 31 June 2022, using a primary care practice based research network.</p><p><strong>Subjects: </strong>Patients with ≥1 prescription for analgesics during the study period were included.</p><p><strong>Main outcome measure: </strong>Changes in the number of prescriptions for paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs) and opioids in Dutch general practice during the 9-year study period. Moreover, we analyzed indications for prescribing strong opioids by the general practitioner (GP).</p><p><strong>Results: </strong>A total of 18,433 analgesic users were identified. Over time, prescriptions for paracetamol, NSAIDs and weak opioids decreased, while the number of strong opioid prescriptions increased. General practitioners prescribed more strong opioids for non-malignant pain, whereas prescriptions for malignant pain remained stable over time. Risk factors for chronic opioid use (≥90 days) included older age, lower educational level, smoking status and having a history of a musculoskeletal or psychological disorder, a malignancy or sexual, physical or psychological abuse.</p><p><strong>Conclusions: </strong>Considering the increase in strong opioid prescriptions for benign conditions, GPs need to be vigilant for patients who are at risk for chronic use. Regular monitoring and awareness for psychosocial factors in treatment of chronic pain may be key in preventing harms associated with persistent opioid use.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"714-722"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Musculoskeletal disorders in Norway: trends in health care utilization and patient pathways: a nationwide register study.","authors":"Mari Kristine Tyrdal, Flavie Perrier, Cecilie Røe, Bård Natvig, Astrid Klopstad Wahl, Marit B Veierød, Hilde Stendal Robinson","doi":"10.1080/02813432.2024.2368848","DOIUrl":"10.1080/02813432.2024.2368848","url":null,"abstract":"<p><strong>Objective: </strong>Describe trends in health care utilization, demographic characteristics and patient pathways among patients with musculoskeletal disorders (MSD) in Norway.</p><p><strong>Design: </strong>Register-based cohort study.</p><p><strong>Settings: </strong>Data were obtained from two Norwegian National registries; the Norwegian Control and Payment of Health Reimbursements Database (KUHR) and the Norwegian Patient Registry (NPR).</p><p><strong>Subjects: </strong>Patients with MSD according to ICPC-2 and ICD-10 during 2014-2017.</p><p><strong>Main outcome measures: </strong>Patient pathways from the first contact and the following two years, described in a Sankey Diagram for all MSD patients and three common diagnoses: spine pain, osteoarthritis (OA) and fibromyalgia (FM).</p><p><strong>Result: </strong>About 26% of the Norwegian population consulted PHC annually while 7% were treated in SHC. Mean age was 47 and 53 years in PHC and SHC, respectively. The proportion of women increased by age. Spine pain was the most common diagnosis; 33% and 22% in PHC and SHC, respectively. Over 90% visited a GP first, 50% of them were treated by PT and/or in SHC during follow-up. Patients visiting the PT first were less likely to be treated in SHC. OA patients were most likely to be treated by more than one health care professional (>70%).</p><p><strong>Conclusion: </strong>One third of the Norwegian population consulted health care services due to MSD annually between 2014-2017. GP was the most consulted health care professional. Among MSD patients with long-term use of health care services, 50% were treated by a PT and/or in SHC in addition to a GP.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"582-592"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality improvement work in general practice; a Norwegian focus group study.","authors":"Torunn Bjerve Eide, Holgeir Skjeie, Sigurd Høye","doi":"10.1080/02813432.2024.2380920","DOIUrl":"10.1080/02813432.2024.2380920","url":null,"abstract":"<p><strong>Background: </strong>Quality improvement work is an essential feature of healthcare services, including general practice. In this study, we aimed to gain more knowledge regarding general practitioners' (GPs) motivation for such work in their practices, as well as what kind of measures were considered motivating and feasible.</p><p><strong>Materials and methods: </strong>We conducted five focus group interviews among Norwegian GPs between November 2021 and November 2022. We included 21 GPs of varying age, gender, experience, and geographic situation. The data were transcribed verbatim and analysed by Systematic Text Condensation, a thematic cross-case analysis.</p><p><strong>Results: </strong>Many GPs had a diverse and imprecise understanding of the term quality improvement, and sound routines in everyday practice were often given as examples of quality improvement measures. There was a universal attitude that quality improvement initiatives should be close to practice, professionally relevant, and sufficiently small to be manageable. The availability of professional communities, either in the GP practices or in continuous medical education groups, was important for motivation. The role of nurses and health secretaries was highlighted as essential to achieve change. Participants commonly described negative reactions to programs that were imposed by external actors without regard for the GPs' perceived needs.</p><p><strong>Conclusion: </strong>GPs were motivated for quality improvement measures provided feasibility within the framework of general practice. Well-functioning professional communities, including involvement of nurses and health-secretaries, were emphasised as requisite for quality improvement. Small scale quality improvement programs suited for the needs of general practice were well received and should be further developed.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"677-685"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monitoring handgrip strength to motivate lifestyle choices for patients with diabetes type 2 - a pragmatic randomised controlled trial.","authors":"Lena Bornhöft, Susanne Bernhardsson, Lena Nordeman, Anna Grimby-Ekman, Maria Dottori, Maria E H Larsson","doi":"10.1080/02813432.2024.2373298","DOIUrl":"10.1080/02813432.2024.2373298","url":null,"abstract":"<p><strong>Methods: </strong>Measurement of HGS with Jamar dynamometers was added to annual check-ups for patients with T2DM by diabetes nurses in primary care with feedback about normal values for age and sex in the intervention group. The control group had standard check-ups. Change in self-reported PA level was measured with questionnaires.</p><p><strong>Results: </strong>Seven clinics and 334 patients participated. The intervention led to similar effects on PA in both groups. Patients with T2DM had comparable HGS to the general public. Regression analyses showed statistically significantly higher HGS in the intervention group than in the control group at follow-up and no improvement in PA, HbA1c, or waist circumference. Increased HGS was found for older people, men, and people with normal-to-high inclusion HGS, while patients with low inclusion HGS reduced their strength levels.</p><p><strong>Conclusions: </strong>Measuring HGS and giving feedback to patients with T2DM can lead to increased HGS but does not seem to affect general PA level, HbA1c, or waist circumference. People over 65 years, men, and people with normal-to-high HGS were influenced positively by the intervention. Patients with low HGS may need personalised support to increase physical activity and improve function.<b>ClinicalTrials registration:</b> NCT03693521.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"617-632"},"PeriodicalIF":16.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141498882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}