A post-trial focus group was held which was attended by 10 doctors and nurse practitioners who had participated in the trial. These were from Hillcrest Medical Centre, Mileara Rd Medical Centre, Dianella Medical Centre and Harding St Medical Centre. Also present were 8 members of the Research team.
Dr Reeva Lederman presented the trial results and Dr Ralph Audehm gave a presentation on new developments in diabetes care. Managed discussion followed about how the trial operated and what positives or negatives it brought to practice. Additionally researches engaged in one to one discussions through the evening with each trial participant about their trial impressions.
Overall doctors were very enthusiastic about the idea that a set of pathology results could be presented in a new way that related it to multiple risk factors and was easily understood by patients.
A synthesis of the discussions follows:
- Overwhelmingly all medical practitioners felt the graph was the most useful part of the pro forma but they agreed that this does not mean that more graphs would be helpful. A single clear graph stands out and has impact and attracted notice from patients.
- There was consensus that further work needs to be done to look at how to incorporate multiple measures: e.g. weight and ldl’s , blood pressure, without the presentation becoming confusing.
- Page 2 was seen to cover other available tools such as diabetes care plans already used and print outs possibly available through the Medical Director software. This did not discount the value of page 2 only that some rationalization needed to be done so replication did not occur. Additionally, some of the other information on cardiac risk etc could be synthesized with already available Medical Director information. This also raised issues of how the research team might engage with proprietors of Medical Director or similar software products.
- GP’s would like such a report to be created at the pathology company end to reduce work at their end.
- There is a lot of confusion among patients around the term HbA1C and this needs to be made clearer.
- Overall there was huge support for the idea of a simple pictorial tool.
- No practice had yet had a repeat visit from a patient or any feedback on whether the report had an impact on compliance.
- An important conclusion was however that even with a better tool patients still needed more motivation for compliance. Lack of compliance was not always a factor of lack of understanding. Consequently doctors were engaged with previous research done by the Melbourne University team on the idea of using patient attributes and values as a way of personalizing reports.