Multidisciplinary care plans for diabetes: how are they used?
OBJECTIVE
To understand how multidisciplinary care plans are being used in the management of patients with diabetes, and to explore the role of collaboration in care planning.


METHODS
Grounded theory interview study.


METHODS
Primary care, June 2005 to October 2006.


METHODS
Thirty-eight people from three New South Wales Divisions of General Practice: 19 general practitioners, eight diabetes-related allied health providers, two endocrinologists, and nine adults with type 2 diabetes. Sampling was purposeful then theoretical.


RESULTS
GPs use care plans to organise clinical care and help patients access allied health providers. Written plans are used to educate patients about their care and to motivate change. GPs rarely discuss care plans with other providers, and providers are unlikely to change their approach to patients on the basis of care plans. Patients do not expect to participate in care planning.


CONCLUSIONS
Care planning may increase evidence-based multidisciplinary care for patients with diabetes, but it rarely results in genuine collaboration between providers and patients. This suggests a difference may exist between Australian policymakers' and providers' definitions of patients with complex needs. Care plans could facilitate patient self-management by including more personalized information. Further research is needed to clarify which patients would benefit from a truly collaborative approach to their care.
Shortus
Timothy D
TD
School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia. t.shortus@student.unsw.edu.au
McKenzie
Suzanne H
SH
Kemp
Lynn A
LA
Proudfoot
Judith G
JG
Harris
Mark F
MF
D003920:Diabetes Mellitus / Q000517:prevention & control / Q000628:therapy*; D005194:Family Practice / Q000379:methods*; D006285:Health Planning / Q000379:methods*; D006801:Humans; D009517:New South Wales; D010348:Patient Care Team; D011320:Primary Health Care / Q000379:methods*