title: Primary care visit preparation and communication for patients with poorly controlled diabetes: A qualitative study of patients and physicians.
abstract: The purpose of this study was to examine how patients with diabetes and their primary care physicians identify and discuss visit priorities prior to and during visits.
  
  
  
  We conducted a qualitative study involving patients with diabetes (4 focus groups, n=29) and primary care physicians (6 provider practice meeting discussions, n=67).
  
  
  
  Four key themes related to prioritization were identified: 1) the value of identifying visit priorities before the visit; 2) challenges to negotiating priorities during the time-limited visit; 3) the importance of "non-medical" priorities; and 4) the need for strategies to help patients prepare for visits. Both patients and physicians felt that identifying a concise list of key priorities in advance of the visit could help establish collaborative visit agendas and treatment plans.
  
  
  
  Identifying and communicating mutually agreed upon priorities for discussion is a key challenge for time-limited primary care visits.
  
  
  
  Communication between primary care physicians and their patients with diabetes could be improved by strategies that help patients identify their top visit priorities before the visit.
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, USA. Electronic address: Richard.W.Grant@KP.org.
authors.forename: Richard William
authors.initials: RW
authors.lastname: Grant
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Altschuler
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, USA.
authors.forename: Connie Si
authors.initials: CS
authors.lastname: Uratsu
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, USA.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Sanchez
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, USA.
authors.forename: Julie Ann
authors.initials: JA
authors.lastname: Schmittdiel
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, USA.
authors.forename: Alyce Sophia
authors.initials: AS
authors.lastname: Adams
authors.affiliation: University of Michigan Department of Internal Medicine, Ann Arbor, USA.
authors.forename: Michele
authors.initials: M
authors.lastname: Heisler
mesh_terms: D001291:Attitude of Health Personnel; D057189:Checklist; D003142:Communication; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006292:Health Priorities; D006801:Humans; D009819:Office Visits; D010817:Physician-Patient Relations; D058007:Physicians, Primary Care / Q000523:psychology*; D011320:Primary Health Care; D036301:Qualitative Research; D013997:Time Factors
keywords: Diabetes; Doctor–patient communication; Primary care