Patient involvement in the encounter between general practice and patients with a chronic disease. Results of a scoping review focusing on type 2 diabetes and obstructive pulmonary disease

Figures & data

Table 1. Search matrix.

Population: patients with chronic disease	Concept: patient involvement	Context: general practice
Chronic disease (MeSH)	Patient participation (MeSH)	General practitioners (MeSH)
Diabetes, Mellitus type 2 (MeSH)	Decision Making (MeSH)	Physicians, Family(MeSH)
Pulmonary disease, Chronic obstructive (MeSH)	Clinical Decision-Making	General practice (MeSH)
	Decision Making, shared (MeSH)	Primary health care (MeSH)
	Self-Management (MeSH)	Family practice (MeSH)
	Empowerment (MeSH)
	Patient care planning (MeSH)
	Self-care (MeSH)
	Patient compliance (MeSh)
	Cooperative behaviour (MeSh)
	Physician-patient relations (MeSh)
Free text
(Chronic disease*) or (Chronic disorder) or (Chronic illness*) or (Diabetes type 2) or (T2D) or (COPD) or (Chronic pulmonary obstructive disease*) or (long-term condition*)	((activati* or participat* or involv* or engag* or influenc* or impact or perspective* or collaborat* or contribut* or adherence or centred or includ* or inclusion or voice* or view* or intergra* or led or partner*) adj2 (patient or client or user or consumer))	(General practi*) or (family practi*) or (family physician*) or (primary care) or (GP)
	Or
	((Co-production adj2 knowledge) or shared decision making or self-management or empowerment or partnership)

Figure 1. Prisma flow diagram.

Table 2. Study characteristics.

Author, year of publication, location	Aim	Study design	Inclusion and exclusion criteria	Design/data collection method	Sampling strategy	Participants’ characteristics (Gender, Age)	Data analysis techniques
Abdulhadi, 2007 (Sweden)	To explore the perceptions of TD2 patients regarding the medical encounters and quality of interactions with their primary healthcare providers.	Qualitative	Patients with TD2 (n = 27)	Focus group interview	Purposive sampling	13 men and 14 women Age range 26–70 years	Qualitative content analysis
Abdulhadi, 2013, (Sweden)	To explore the experiences of primary healthcare providers of their encounters with patients with TD2, and their preferences and suggestions for future improvement of diabetes care	Qualitative	General practitioners (n = 19)	Semi-structured interview	Purposive sampling	8 women, 11 men, Age range 29–55 years	Qualitative content analysis
Ball, 2016 (Australia)	To examine the perceptions of patients who have been recently diagnosed with TD2 regarding nutrition care provided by primary healthcare professionals	Qualitative	Patients with TD2 (n = 10)	Semi-structured telephone interviews	Purposive sampling	3 men, 7 women, Age range 27–74 years.	Content analysis and meta-synthesis of findings over time
Burridge, 2016 (Australia)	Patients’ perceptions and experiences of TD2 selfcare and engagement with GP-led integrated diabetes care	Qualitative	Patients with TD2 (n = 30)	Interviews	Purposive sampling	14 women and 16 men. Mean age: 60.2	Thematic analysis
Dambha-Miller, 2018 (UK)	To explore patients’ views on factors within patient-practitioner interactions that are of significance to them after diagnosis and over a 10-year experience of living with the disease	Mixed methods	Patients with TD2 (n = 311) 1 year follow-up. (n = 110) 10 year follow-up. (n = 46) both times.	Survey – Free text comments	Not described	1 year follow up: 196 men/142 women. Mean age 60 years old. 10 year follow up. 53 men/48 women. Mean age 72 years old.	Descriptive analysis. Cross-sectionally analysis
Dao, 2019 (Australia)	To explore the factors influencing self-management of TD2 in patients attending general practice in southwest Sydney from both a patient and provider perspective. A secondary aim was to assess how consistent the findings were with the socio-ecological model	Qualitative	Patients with TD2 (n = 10) General practitioner (n = 4)	Semi-structured interviews	Purposive sampling	Patients: 6 women and 4 men. Age range 30–79. GP: 6 women, and 4 men. Age range 30–79.	Thematic analysis
Dowell, 2018 (New Zealand)	To observe in detail the primary care interactions and communications of patients with newly diagnosed diabetes over time. In addition to identify key points on the process where miscommunication might occur	Qualitative	Patients with TD2 (n = 32) General practitioner (n = ?)	Video Recording	Purposive sampling	Not described	Ethnography and interaction analysis
Grant, 2016 (USA)	To examine how patients with TD2 and their primary care physicians identify and discuss visits prior to and during visits.	Qualitative	Patients with TD2 (n = 29) General practitioner (n = 67)	Qualitative interviews and focus group	Purposive sampling	Patients: Age range 35–80) 14 women and 15 men. Primary care providers (61%) women.	Modified grounded theory approach with an inductive approach
Halliwell, 2016 (New Zealand)	To identify strategies that general practitioners can use to facilitate discussions of prognosis with patients who have COPD	Qualitative	General practitioner (n = 15)	Telephone interviews	Purposive sampling	7 women and 8 men. Age range 31–60	General inductive approach
Heisler, 2003 (USA)	To assess the extent to which patients with TD2 agree with their primary care provider on diabetes treatment goals and strategies, the factors that predict agreement and whether greater agreement is associated with better patient self-management of diabetes	Survey	Patients with TD2 (n = 123) General practitioner (n = 50)	Survey	Randomly sample	Patients: Mean age 65, 81% male. Providers mean age 40, 56% men	Descriptive statistics
Laue, 2016 (Norway)	To explore the decision-making of general practitioners concerning treatment with antibiotics and/or oral corticosteroids and hospitalisation for COPD patients with exacerbations	Qualitative	General practitioner (n = 53)	Focus group interview	Purposive sampling	Not described	Thematic analysis
Oftedal, 2020 (Norway)	How adults with TD2 perceive different attributes of support provided by healthcare practitioners and how various attributes of support can influence peoples’ motivation to self-manage their diseases	Qualitative	Patients with TD2 (n = 19)	Focus group interviews	Purposive sampling	12 men, 7 women. Median age 54, 52, 42	Content analysis
Parchman, 2010 (USA)	To examine a causal model linking participatory decision making to improved clinical outcomes that included patient activation and medication adherence	Mixed methods	Patients withTD2 (n = 144)	Observations and questionnaires	5 independent primary care practices	Mean age 57.7 years. 61% women and 39% mean.	Path analysis using a structural equation model
Pooley, 2001 (UK)	To explore people with TD2 and healthcare professionals who deliver their diabetes care. To explore the issues that they perceive as central to effective management of diabetes, primarily within a primary care setting	Qualitative	Patients with TD2 (n = 47) General practitioner (n = 7)	Focus group interviews	Randomly selected	Not described	Qualitative (thematic) analysis
Shortus, 2013 (Australia)	To investigate provider perspectives on the role of patient involvement in chronic disease decision making	Qualitative	General practitioner (n = 19) (+ 8 allied health providers, and 2 endocrinologists)	Interviews	Purposive sampling	Not described	Grounded theory
Syed, 2017 (Malaysia)	To investigate whether the use of a patient decision aid for insulin initiation fulfils its purpose of facilitating patient-centred decision making through identifying how doctors and patients interact when using the PDA during Primary care consultations	Qualitative	Patients with TD2 (n = 7) General practitioner (n = 7)	Audio- or video-recorded consultations (n = 15)	Purposive sampling	GPs: 1 man, 6 women Patients: 2 men, 5 women; age range 50–73)	Conversation analysis
Vermeire, 2003 (Belgium)	To examine the health beliefs of people living with TD2, the way they communicate about it, and the problem they encounter in adhering to therapeutic regimens	Qualitative	Patients with TD2 (n = 46)	Focus group interviews and observations	Focus groups divided by gender.	21 men, 25 women. Age range 40–80.	Thematic analysis
Wens, 2005 (Belgium)	To examine explicitly the physicians’ expectations of their diabetes patient compliance/adherence. Objectives: 1) elicit problems physicians encounter with TD2 diabetes patients’ adherence to treatment recommendations; 2) to search for solutions and 3) to discover escape mechanisms in case of frustration	Qualitative	General practitioners (n = 40)	Focus group interviews and observations	By interest	26 women, 14 men. Mean age 45.3. Mean years in practice 18.4	Content analysis

Data availability material

Full search string available as supplementary material.