Supporting those with a Multimorbidity. A Qualitative Study on the Perspectives of Healthcare Professionals who Provide Care to Individuals with Type 2 Diabetes and Cardiovascular Disease, 2023-2024

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Type 2 Diabetes and cardiovascular disease frequently co-exist as multimorbid conditions due to their shared pathophysiological mechanisms and overlapping treatment needs. Effective management requires coordinated patient centred care, however there is limited qualitative accounts understanding how support is provided to those who live with T2D and CVD collectively. Thus, the present study aims to bridge the gap by providing in depth explorations of practitioner’s perception and practices regarding the management of these conditions. Thirteen community practitioners and three hospital-based clinicians were recruited, and raw data was analysed using Reflexive Thematic Analysis. Three core themes and six sub themes were generated: first, current care, second, structural challenges, and third, psychological perceptions of multimorbidity. Importantly, the data demonstrated inconsistencies in how healthcare professionals conveyed risk information, with some suggesting the monitoring of biological complications alone is sufficient for managing morbidity. Further, multifaceted barriers within the structure of care and lack of cohesion between teams highlighted how support is not always optimised for those living with complex needs. Moreover, psychological issues were recognised by all healthcare professionals, however most lacked confidence providing this sort of support, and several commented on the lack of suitable services for those mentally struggling with chronic health conditions. This study underscores the need for improved communication and a more integrated approach to care, however until complex systemic issues are resolved multimorbidity management will remain minimal.

Type 2 Diabetes and cardiovascular disease frequently co-exist as multimorbid conditions due to their shared pathophysiological mechanisms and overlapping treatment needs. Effective management requires coordinated patient centred care, however there is limited qualitative accounts understanding how support is provided to those who live with T2D and CVD collectively. Thus, the present study aims to bridge the gap by providing in depth explorations of practitioner’s perception and practices regarding the management of these conditions. Thirteen community practitioners and three hospital-based clinicians were recruited, and raw data was analysed using Reflexive Thematic Analysis. Three core themes and six sub themes were generated: first, current care, second, structural challenges, and third, psychological perceptions of multimorbidity. Importantly, the data demonstrated inconsistencies in how healthcare professionals conveyed risk information, with some suggesting the monitoring of biological complications alone is sufficient for managing morbidity. Further, multifaceted barriers within the structure of care and lack of cohesion between teams highlighted how support is not always optimised for those living with complex needs. Moreover, psychological issues were recognised by all healthcare professionals, however most lacked confidence providing this sort of support, and several commented on the lack of suitable services for those mentally struggling with chronic health conditions. This study underscores the need for improved communication and a more integrated approach to care, however until complex systemic issues are resolved multimorbidity management will remain minimal.