Enhanced community care for type 2 diabetes in Ireland: the patient's perspective on attending an integrated care centre.

BACKGROUND

Chronic diseases, particularly type 2 diabetes mellitus (T2DM), present significant challenges to Ireland's healthcare system. Sláintecare's Enhanced Community Care (ECC) initiative involves the nationwide establishment of integrated care centres (also known as hubs) that facilitate specialist management of T2DM within the community. This study evaluated the experience of people living with Diabetes (PWD) attending the Dublin North West (DNW) hub as part of this novel paradigm of T2DM care.

METHODS

Consecutive PWD attending the hub T2DM service completed a standardized questionnaire on various aspects of their T2DM care. The hub operates as a multidisciplinary service designed to provide comprehensive diabetes management. Staff members include diabetes specialist nurses, podiatrists, endocrinologists, and dietitians, ensuring a holistic approach to patient care. The service aims to integrate these specialties to address the diverse challenges associated with T2DM management.

RESULTS

In total, 40 PWD completed the study, of which 35 (87.5%) were satisfied or very satisfied with the care they had received in the hub. Notably, 34 (85%) patients indicated a preference for community-based T2DM management with their general practitioner (GP) in the future (GP alone or their GP with hub support). With regards to opportunities for "making every contact count" (MECC); 17 (42.5%) of patients reported discussions had taken place about smoking cessation, 23 (57.5%) about weight loss,33 (82.5%) about nutrition, 21(52.5%) about alcohol use and 25 (62.5%) about mental health.

DISCUSSION: This is the first study to report on the T2DM patient's experience as part of ECC in Ireland. It is notable that patient preference was for continued follow up of their diabetes within the community as opposed to the hospital, and that additional opportunities for MECC interventions were identified within the community setting.