A 360° Approach to Personalize Lifestyle Treatment in Primary Care for People with Type 2 Diabetes: A Feasibility Study (Preprint)

BACKGROUND Healthcare around type 2 diabetes (T2D) would benefit from a holistic approach and multidisciplinary consultation. Therefore, we developed the web-based 360-degree (360°) diagnostic tool. OBJECTIVE The 360° diagnostic tool and subsequent tailored treatment (360° approach) were evaluated in a 6-month intervention and feasibility study in standard primary healthcare. METHODS A baseline, 3- and 6-months follow-up single group design was used. Fifteen people with T2D and their healthcare providers of two practices participated. The 360° diagnosis included clinical measurements of physical health, and self-reported lifestyle, mental health and socio-economic environmental factors. After multidisciplinary consultation between general practitioner, pharmacist, nurse practitioner and dietician, the two latter professionals provided tailored advice, lifestyle treatment and continuous support. RESULTS Participants with T2D and professionals were positive about the 360° approach. Promoting factors were i. the care, attention, support and experience of professionals, ii. the multidisciplinary team, iii. the social support and iv. experiencing positive health effects. Hindering factors were i. too much information, ii. survey-related issues, and iii. time-consuming counselling. The data showed an increase in mental health, and a decrease in problems with diabetes, perceived stress, fruit intake and fast-food consumption over time. CONCLUSIONS Overall, it seems feasible to implement the 360° approach in standard primary healthcare. Also, the 360° approach was favorably evaluated by people with T2D and professionals. CLINICALTRIAL the Medical Ethics Committee Brabant (NL67846.028.18; at January 8, 2019)