Personalised care and support planning in Singapore: qualitative interviews with people living with diabetes

Monica Lazarus; Tong Wei Yew; Wee Hian Tan; Kavita Venkataraman; Jose Maria Valderas; Doris Yee Ling Young; E Shyong Tai; Victor Weng Keong Loh

doi:10.3399/BJGPO.2023.0055

Personalised care and support planning in Singapore: qualitative interviews with people living with diabetes

BJGP Open. 2024 Apr 25;8(1):BJGPO.2023.0055. doi: 10.3399/BJGPO.2023.0055. Print 2024 Apr.

Authors

Monica Lazarus¹, Tong Wei Yew^{1

2}, Wee Hian Tan³, Kavita Venkataraman⁴, Jose Maria Valderas^{1

5}, Doris Yee Ling Young¹, E Shyong Tai^{1

2

4}, Victor Weng Keong Loh^{6

5}

Affiliations

¹ Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore, Singapore.
² Department of Medicine, National University Hospital (NUH), Singapore, Singapore.
³ National University Polyclinics (NUP), Singapore, Singapore.
⁴ Saw Swee Hock School of Public Health, National University of Singapore (NUS), Singapore, Singapore.
⁵ Department of Family Medicine, National University Health System (NUHS), Singapore, Singapore.
⁶ Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore, Singapore mdclwkv@nus.edu.sg.

PMID: 37945006
DOI: 10.3399/BJGPO.2023.0055

Abstract

Background: Personalised care and support planning (CSP) is a person-centred approach for the care of people living with long-term conditions. Patient Activation through Community Empowerment/Engagement for Diabetes Management (PACE-D) adapts the Year of Care Partnerships (YOCP) approach to CSP in the UK for people living with diabetes at Singapore polyclinics. Polyclinics are multi-storey primary care hubs that provide affordable, multidisciplinary, comprehensive, and high-throughput public health care for the multi-ethnic, multilingual Singapore population.

Aim: To explore the experience of PACE-D-enrolled people living with diabetes with personalised CSP at Singapore polyclinics.

Design & setting: Qualitative interviews of people living with diabetes who experienced personalised CSP at National University Polyclinics (NUP) in Singapore between July 2020 and November 2021.

Method: PACE-D-enrolled people living with diabetes who experienced personalised CSP were purposively sampled. In-depth semi-structured interviews were recorded, transcribed, and analysed using Braun and Clarke's reflexive thematic analysis.

Results: Fifty-two patients participated in the study. Four main themes were identified. Theme 1 was the importance of the care-planning letter. Patients reported that the CPL prompted reflection and patient preparation for CSP conversations. Theme 2 was the role of the programme coordinator. PACE-D programme coordinators amplified self-management by playing advocate and confidant beyond administrative duties. Theme 3 was the value of the personalised CSP conversation. CSP providers were perceived as partners in care, with more time to listen compared with usual consultations. Patient engagement was affected by language confidence. Theme 4 was agency in self-management. With adequate time and support, patients increased in confidence and agency both in CSP engagement and diabetes self-management.

Conclusion: While language confidence may affect patient engagement, personalised CSP shows promise for strengthening patient engagement and self-management among people living with diabetes at Singapore polyclinics.

Keywords: diabetes mellitus; personalised care and support planning; primary health care; qualitative research.