Factors associated with medication information in diabetes care: differences in perceptions between patients and health care professionals

Figures & data

Table 1 Characteristics of patients with type 2 diabetes who participated in the focus groups

Patient characteristics	Patient focus groups (n=25)
Sex, women, n (%)	7 (28)
Age (years), mean ± SD, range	64±8.6, 49–77
Number of years diagnosed with diabetes, mean ± SD, range	13.9±10.6, 0.8–38
Number of other chronic conditions, mean ± SD, range	3.4±1.6, 1–7
First language German/Turkish, n (%)	18 (72)/7 (28)
Number of different medicines per day*, n (%)
1–2 medicines	2 (8)
3–4 medicines	6 (24)
5–6 medicines	5 (20)
≥7 medicines	12 (48)
Diabetes medication, n (%)
Oral hypoglycemic agents only	13 (52)
Insulin only	3 (12)
Oral hypoglycemic agents and insulin	9 (36)
Education, n (%)
Secondary school (9 yr)	12 (48)
Secondary modern school (10 yr)	5 (20)
Grammar school (13 yr)	8 (32)
Living in partnership, n (%)	14 (56)
Feeling burdened,a mean ± SD, range	4.96 (2.5), 0–10
Recruitment through, n (%)
Self-help groups	15 (60)
University Hospital of Heidelberg	6 (24)
General practitioner practices	4 (16)

Notes:

* Not restricted to diabetes medication.

a Scale 1–10; 10= feeling heavily burdened.

Abbreviations: SD, standard deviation; yr, number of years of schooling/education that the person had.

Table 2 Characteristics of participating health care professionals

Health care professional characteristics	Professional focus groups
	GPs (n=13)	HCAs (n=10)
Sex, women, n (%)	6 (46.2)	10 (100)
Age (years), mean ± SD, range	54.1±9.2, 35–64	38.6±11.8, 21–52
Structure of practice, n (%)
Solo practice	4 (30.8)	4 (40)
Group practice	7 (53.8)	6 (60)
Practice sharing	1 (7.7)
Ambulatory health center	1 (7.7)
Years of work experience, mean ± SD, range	24.5±9.8, 6–40	15.5±12.5, 0–35
Participation in DMP diabetes type 2, n (%)	13 (100)	10 (100)
Recruitment through, n (%)
Academic teaching practices	12 (92.3)	8 (80)
Research practices	1 (7.7)	2 (20)

Abbreviations: GP, general practitioner; HCA, health care assistant; SD, standard deviation; DMP, disease management program.

Table 3 Factors perceived by patients and health care professionals to enhance medication information provision

Subcategory	Code	Source
Tailored, adequate information	Face-to-face and responsive communication	P, HCP
	Reference to clinical parameters, overall therapy, considering health condition and life situation	P, HCP
	Proactive, timely provision of relevant information	P, HCP
	Use of lay language	P, HCP
	Stepwise and repeated provision	P, HCP
	Consideration of patients’ resources and capacity	P, HCP
Trusting patient–provider relationship	Trust and continuity being a necessary basis	P, HCP
	Pivotal role of GPs in coordinating care	P, HCP
	Responsiveness of provider	P
Medication reconciliation	Prerequisite to adequate information delivery	P, HCP
	Confidence in medication compatibility	P
	DMP supports medication management	HCP
	Brown bag review initiated on suspicion of polypharmacy, overuse, or non-adherence, etc	HCP
Tools for medication management	Medication plan adjusted to patients’ needs	P, HCP
	Medication plan/graphs to facilitate proper use	P, HCP
	Supporting patients’ daily self-management	P
	Updated medication plan supports providers’ medication management	HCP
Team approach to medication communication	Professional cooperation	HCP
	Directing patients to further training	HCP

Abbreviations: P, perceptions of patients with type 2 diabetes; HCP, health care professionals’ perceptions; GP, general practitioner; DMP, disease management program.

Table 4 Factors perceived by patients and health care professionals to impede medication information provision

Subcategory	Code	Source
Inadequate information	Conflicting information from different sources	P, HCP
	Not user-friendly, overload with certain information	Pa
	Insufficient information, dependent on discretion of provider	Pa
	Patients’ forgetting information	HCPa
	Family members and friends being opinion formers	HCPa
Lack of/overload of information on potential adverse effects	Information not proactively provided	Pa
	Lack of information causes uncertainty/noncompliance	Pa
	Lack of guidance how to cope with adverse effects	Pa
	Detailed information creates fear/nonadherence	HCPa
	Risks and benefits are not balanced in patient information leaflets	HCPa
Medication reconciliation impeded	Lack of cross sectorial collaboration/full medication overview impeded	P, HCP
	Lack of discussion of overall medication	Pa
	Time consuming	HCP
	No reimbursement	HCP
	Lack of patients’ mutual collaboration	HCPa
Lack of support for medication self-management	Overwhelmed with insulin administration	P, HCP
	Predetermined treatment plan not fitting daily life	P, HCP
	Self-management is challenging	P
	Planning medication use and administration	P
	Loss of security due to medication changes	P
System-related barriers	Restricted consultation time/no reimbursement	P, HCP
	Drug discount contracts confuse patients	P, HCP
	Lack of transparency of reimbursement system	P
	Drug discount contracts impose challenges on practices/black box for physicians	HCP
	Deficient medication labeling	HCP

Note:

a Conflicting perceptions.

Abbreviations: P, perceptions of patients with type 2 diabetes; HCP, health care professionals’ perceptions.