Evidence map›Paper›PMID 39282819›Full record

ArticlePrimary health care research & development2024

General practitioner and nurse experiences of type 2 diabetes management and prescribing in primary care: a qualitative review following the introduction of funded SGLT2i/GLP1RA medications in Aotearoa New Zealand.

Kimberley Norman, Sara Tareq Mustafa, Shemana Cassim, Hilde Mullins, Penny Clark, Rawiri Keenan, Leanne Te Karu, Rinki Murphy, Ryan Paul, Tim Kenealy and 1 more

Abstract read
In one paragraph

Article in Primary health care research & development, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Kimberley NormanSchool of Primary and Allied Health Care, Monash University, Melbourne, Australia.ORCID 0000-0003-4278-5451
Sara Tareq MustafaMedical Research Centre, Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand.ORCID 0000-0001-5902-5622
Shemana CassimSchool of Psychology, Massey University, Auckland, New Zealand.
Hilde MullinsDepartment of Nursing, Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand.
Penny ClarkNorthcare Medical Centre, Hamilton, New Zealand.
Rawiri KeenanMedical Research Centre, Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand.ORCID 0000-0001-8312-8525
Leanne Te KaruFaculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.ORCID 0000-0002-8645-3937
Rinki MurphyFaculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.ORCID 0000-0002-0043-2423
Ryan PaulMedical Research Centre, Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand.
Tim KenealyFaculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Lynne ChepulisMedical Research Centre, Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand.ORCID 0000-0002-9661-4669

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo explore the views of general practitioners (GPs) and nurses on type 2 diabetes (T2D) management, including the use of recently funded T2D medications in New Zealand (NZ) and their perceived barriers to providing optimal care.

backgroundT2D is a significant health concern in NZ, particularly among Māori and Pacific adults. Characterised by prolonged hyperglycaemia, T2D is generally a progressive condition requiring long-term care.

methodsSemi-structured interviews were conducted between July and December 2022 with 21 primary care clinicians (10 GPs and 11 nurses/nurse prescribers) from nine different general practice clinics across the Auckland and Waikato regions of NZ. Framework analysis was conducted to identify common themes in clinicians' perceptions and experiences with T2D management.

findingsThree themes were identified: health-system factors, new medications, and solution-based approaches. Lack of clinician time, healthcare funding, staff shortages, and burn-out were identified as barriers to T2D management under health-system factors. The two newly funded medications, empagliflozin and dulaglutide, were deemed to be a positive change for T2D care in that they improved patient satisfaction and clinical outcomes, but several clinicians were hesitant to prescribe these medications. Participants suggested that additional education and specialist diabetes support would be helpful to inform optimal medication prescribing and that better use of a multi-disciplinary team (clinical and support staff) could support T2D care by reducing workload, addressing cultural gaps in healthcare delivery, and reducing burnout. An improved primary care work environment, including appropriate professional development to support prescribing of new medications and the value of collaboration with a non-regulated workforce, may be required to facilitate optimal T2D management in primary care. Future research should focus on interventions to increase support for both clinical teams and patients while adopting a culturally appropriate approach to increase patient satisfaction and improve health outcomes.

Indexed as

Diabetes Mellitus, Type 2Sodium-Glucose Transporter 2 InhibitorsAdultAttitude of Health PersonnelFemaleGeneral PractitionersGlucagon-Like Peptide-1 Receptor AgonistsHumansHypoglycemic AgentsInterviews as TopicMaleMiddle AgedNew ZealandNursesPractice Patterns, Physicians'Primary Health CareGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsSodium-Glucose Transporter 2 Inhibitorsmedicationprimary health carequalitative researchtype 2 diabetes

Identifiers

PMID39282819
PMCPMC11464800

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.