Primary care visit preparation and communication for patients with poorly controlled diabetes: A qualitative study of patients and physicians.

OBJECTIVE: 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.

METHODS: 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).

RESULTS: 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.

CONCLUSIONS: Identifying and communicating mutually agreed upon priorities for discussion is a key challenge for time-limited primary care visits.

PRACTICE IMPLICATIONS: 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.