Challenges to Introducing Integrated Diabetes Care to an Inner-Regional Area in South Western Sydney, Australia

Reetu Zarora; Rati Jani; Freya MacMillan; Anna Pham; Ally Dench; David Simmons

doi:10.5334/ijic.4692

Challenges to Introducing Integrated Diabetes Care to an Inner-Regional Area in South Western Sydney, Australia

Int J Integr Care. 2020 May 5;20(2):6. doi: 10.5334/ijic.4692.

Authors

Reetu Zarora¹, Rati Jani², Freya MacMillan³, Anna Pham⁴, Ally Dench⁵, David Simmons¹

Affiliations

¹ Macarthur Clinical School, School of Medicine, Western Sydney University, Campbelltown, New South Wales, AU.
² Nutrition and Dietetics, Faculty of Health, University of Canberra, Australian Capital Territory, AU.
³ School of Health Science, Western Sydney University, Locked Bag 1797, Penrith, New South Wales, AU.
⁴ Picton Family Medical Centre, Wollondilly, New South Wales, AU.
⁵ Community and Corporate, Wollondilly Shire Council, Wollondilly, New South Wales, AU.

Abstract

Introduction: Diabetes care often requires collaboration between general practitioners, allied health professionals, nurses, and/or medical specialists. This study aimed to describe the establishment of an integrated diabetes prevention and care approach in an area with limited access to primary and secondary care, and the challenges faced in its initial development.

Description: A qualitative research approach to identify challenges was taken. Data included meeting minutes, observational data and reports involving local clinical and non-clinical stakeholders from June 2016- December 2018 and were thematically analysed.

Discussion: Key challenges were low patient attendance in general practice, healthcare professional time, low participation at health promotion activities/peer support groups and diabetes education reflecting a low priority among people with and at risk of diabetes. Coordination between services remained a challenge.

Conclusion: This study highlights the need to integrate new diabetes services with existing health activities in the community and the importance of allowing flexibility and regular contact with local healthcare professional and community to encourage their involvement. Regular meetings with the funders, internal and external stakeholders are key for sustainability and to adapt programmes to the local situation. Further work is needed to identify and implement strategies to overcome these challenges.

Keywords: diabetes mellitus; integrated care; peer group; rural health.

Grants and funding

The diabetes service was funded by South Western Sydney Local Health District and Wollondilly Health Alliance. The evaluation of the diabetes service was funded by the South Western Sydney Local Health District funded Diabetes Obesity and Metabolism Translational Research Unit and by a Western Sydney University Doctor of Philosophy scholarship.