This review also found mixed views on the value of preventative services within primary care .
The third theme was centred on professional factors impacting on diabetes prevention which included workload , time constraints , re sources , self-efficacy and knowledge as well as professionals ' perception of patient motivations towards change .
BACKGROUND Type 2 diabetes is impacting millions of people globally ; however , many future cases can be prevented through lifestyle changes and interventions .
Primary care is an important setting for diabetes prevention , for at-risk population s , because it is a patient 's primary point of contact with the health care system and professionals can provide lifestyle counselling and support , as well as monitoring health outcomes .
These are all essential elements for diabetes prevention for at-risk adults .
AIM To underst and the factors related to the delivery and uptake of type 2 diabetes prevention interventions within primary care in higher income countries .
CONCLUSION This review explored the factors influencing diabetes prevention in primary care , and identified the context of prevention , as well as patient and professional factors related to preventative services being offered in primary care .
Physicians’ participatory decision-making and quality of diabetes care processes and outcomes: results from the triad study
Objectives : In participatory decision-making ( PDM ) , physicians actively engage patients in treatment and other care decisions . Patients who report that their physicians engage in PDM have better disease self-management and health outcomes .  We examined whether physicians ’ diabetes-specific treatment PDM preferences as well as their self-reported practice s are associated with the quality of diabetes care their patients receive . Methods : 2003 cross-sectional survey and medical record review of a r and om sample of diabetes patients ( n = 4198 ) in 10 US health plans across the country and their physicians ( n = 1217 ) . We characterized physicians ’ diabetes care PDM preferences and practice s as ‘ no patient involvement , ’ ‘ physician-dominant , ’ ‘ shared , ’ or ‘ patient-dominant ’ and conducted multivariate analyses examining their effects on the following : ( 1 ) three diabetes care processes ( annual hemoglobin A1c test ; lipid test ; and dilated retinal exam ) ; ( 2 ) patients ’ satisfaction with physician communication ; and ( 3 ) whether patients ’ A1c , systolic blood pressure ( SBP ) , and low-density lipoprotein cholesterol ( LDL ) were in control . Results : Most physicians preferred ‘ shared ’ PDM ( 58 % ) rather than ‘ no patient involvement ’ ( 9 % ) , ‘ physici and ominant ’ ( 28 % ) or ‘ patient dominant ’ PDM ( 5 % ) . However , most reported practicing ‘ physician-dominant ’ PDM ( 43 % ) with most of their patients , rather than ‘ no patient involvement ’ ( 13 % ) , ‘ shared ’ ( 37 % ) or ‘ patient-dominant ’ PDM ( 7 % ) . After adjusting for patient and physician-level characteristics and clustering by health plan , patients of physicians who preferred ‘ shared ’ PDM were more likely to receive A1c tests [ 90 % vs. 82 % , AOR : 2.05 , 95 % CI : 1.03—3.07 ] and patients of physicians who preferred ‘ patient-dominant ’ treatment decision-making were more likely to receive lipid tests [ 60 % vs. 50 % , AOR : 1.58 , 95 % CI : 1.04—2.39 ] than those of providers who preferred ‘ no patient involvement ’ in treatment decision-making . There were no differences in patients ’ satisfaction with their doctor ’s communication or control of A1c , SBP or LDL depending on their physicians ’ PDM preferences . Physicians ’ self-reported PDM practice s were not associated with any of the examined aspects of diabetes care in multivariate analyses . Conclusions : Patients whose physicians prefer more patient involvement in decision-making are more likely than patients whose physicians prefer more physician-directed styles to receive some recommended risk factor screening tests , an important first step toward improved diabetes outcomes . Involving patients in treatment decision-making alone , however , appears not to be sufficient to improve biomedical outcomes
This review also found mixed views on the value of preventative services within primary care .
The third theme was centred on professional factors impacting on diabetes prevention which included workload , time constraints , re sources , self-efficacy and knowledge as well as professionals ' perception of patient motivations towards change .
BACKGROUND Type 2 diabetes is impacting millions of people globally ; however , many future cases can be prevented through lifestyle changes and interventions .
Primary care is an important setting for diabetes prevention , for at-risk population s , because it is a patient 's primary point of contact with the health care system and professionals can provide lifestyle counselling and support , as well as monitoring health outcomes .
These are all essential elements for diabetes prevention for at-risk adults .
AIM To underst and the factors related to the delivery and uptake of type 2 diabetes prevention interventions within primary care in higher income countries .
CONCLUSION This review explored the factors influencing diabetes prevention in primary care , and identified the context of prevention , as well as patient and professional factors related to preventative services being offered in primary care .