Experiences of Veterans With Diabetes From Shared Medical Appointments
Limitations
One of the strengths of this study is that to the authors’ knowledge, this is the first report of findings from a focus group on motivating factors and barriers for veterans with diabetes who had attended an SMA in a primary care setting. Although the study was small, the participation rate was high.
The study had a few limitations. The results might not be applicable to other populations, because all participants were veterans, predominantly male with T2DM. Selection bias is possible, because participants had already attended SMA classes. Participants may have been biased in their providing positive feedback of the SMA classes, since SMA facilitators held this focus group.
Conclusions
The study findings have several implications. Weight gain was ranked as the greatest barrier to self-managing diabetes in this focus group. Veterans stated they had limited resources, which could impact their AADE 7 self-care activities of being active and healthy eating. As resources allow, cooking classes, gym memberships, and VA-affiliated exercise facilities may be beneficial. Since there was heterogeneity in veteran experiences during diabetes diagnosis, consistent information should be provided upfront, including general concepts of diabetes and available resources.
This diabetes focus group highlighted the challenges of having a double identity, of being both a veteran and having diabetes. Shared medical appointments with veteran cohorts were identified as a promising intervention that allows for camaraderie and shared narratives to be enhanced by clinical guidance and education. By providing social support, SMAs may nudge fellow veterans to act on barriers that have them “stuck” in certain behaviors or situations. Many veterans view A1c as an important motivator, and this should be considered as a general educational tool.
Author disclosures
The authors report no actual or potential conflicts of interest with regard to this article.
Disclaimer
The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner, Frontline Medical Communications Inc., the U.S. Government, or any of its agencies. This article may discuss unlabeled or investigational use of certain drugs. Please review the complete prescribing information for specific drugs or drug combinations—including indications, contraindications, warnings, and adverse effects—before administering pharmacologic therapy to patients.
