Qualitative study uncovers systemic barriers to continuous diabetes care in older adults, highlighting the need for integrated health records and community support.
Key Points
To explore how continuity of diabetes care for older adults is experienced by healthcare workers, patients, volunteers, and family caregivers, and to identify key priorities for service improvement.
Conducted a descriptive qualitative study from December 2024 to February 2025 across four kelurahan in the catchment area of Puskesmas Babakan Sari, Bandung, Indonesia.
Purposively recruited 52 participants (16 health workers, 12 older adults with diabetes, 12 community health volunteers, and 12 family caregivers) for face-to-face semi-structured interviews (20–70 minutes).
Analyzed verbatim transcripts using hybrid deductive–inductive content analysis guided by Meiqari and colleagues' continuity-of-care framework and reported according to COREQ guidelines.
Generated five core themes: entering the pathway, information that does not travel, trust as a bridge, keeping care moving, and when care becomes hard to sustain.
Identified that care continuity was undermined by manual records, absent post-screening tracking, one-way referrals lacking return information, brief counseling time, treatment fatigue, and transport constraints.
Highlighted stakeholder priorities for reform, including integrated health records, operational counter-referral systems, family-inclusive counseling, structured volunteer supervision, and flexible follow-up.