Health care providers’ perspective on using family history in the prevention of type 2 diabetes: a qualitative study including different disciplines

BMC Family Practice

Research Article

Suzanne CM van Esch¹  Frank J Snoek¹  Wilmy Cleijne¹  Wieke H Heideman¹  Martina C Cornel² 

[1] Department of Medical Psychology, VU University Medical Center, Van der Boechorststraat 7, Amsterdam, The Netherlands;EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, Amsterdam, The Netherlands;EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, Amsterdam, The Netherlands;Department of Clinical Genetics, VU University Medical Center, Van der Boechorststraat 7, Amsterdam, The Netherlands;

关键词: Type 2 diabetes;    Family history;    Primary prevention;    Family health;    Health promotion;    Family communication;    Interview study;   

DOI  :  10.1186/1471-2296-14-31

 received in 2012-11-08, accepted in 2013-03-04,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundFamily history (FH) is considered an important factor to detect individuals at increased risk developing type 2 diabetes (T2D). Moreover, FH information could be used to personalise risk messages, which are assumed to increase risk-reducing behaviours. In this study, we aimed to explore Dutch health care professionals’ attitudes regarding current or future uptake of a more extensive use of FH information and the family system in diabetes prevention.MethodsSemi-structured interviews were conducted with nineteen health care professionals from six general practices and four outpatient diabetes clinics. The use of FH information in opportunistic screening for T2D was explored, as well as the usability of a direct versus patient-mediated targeting strategy to reach persons with a FH of T2D. Three researchers analysed the interview transcripts separately.ResultsDutch health care professionals considered FH an important risk factor in opportunistic screening for T2D. However, none of them used FH to promote risk-reducing behaviours. Directly targeting and educating patients known to have a FH of T2D was desirable for most primary care professionals, but not considered feasible. Findings indicated that FH information was not systematically gathered in primary care settings and electronic medical records were not equipped to retrieve persons with T2D running in their family. The idea of asking patients to pass on risk and preventive information was new to all interviewees, but was considered an acceptable strategy to reach persons with a FH of diabetes. Nevertheless, there were concerns about the accuracy of the messages delivered by the patients to their relatives. Practical barriers with regard to time, expertise, and financial reimbursement were also mentioned.ConclusionsThere is great interest among healthcare professionals in primary as well as secondary care about the use of FH to prevent T2D, but there are significant barriers against such use. The removal of these barriers would depend on evidence showing the cost-effectiveness of FH-based strategies designed to prevent T2D.

【 授权许可】

CC BY   
© van Esch et al; licensee BioMed Central Ltd. 2013