{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T15:28:07Z","timestamp":1789399687562,"version":"build-2803163510"},"reference-count":53,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T00:00:00Z","timestamp":1726444800000},"content-version":"unspecified","delay-in-days":259,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Prim Health Care Res Dev"],"published-print":{"date-parts":[[2024]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S1463423624000264_as1\">\n\t    <jats:title>Aim:<\/jats:title>\n\t    <jats:p>To explore the views of general practitioners (GPs) and nurses on type 2 diabetes (T2D) management, including the use of recently funded T2D medications in New Zealand (NZ) and their perceived barriers to providing optimal care.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1463423624000264_as2\">\n\t    <jats:title>Background:<\/jats:title>\n\t    <jats:p>T2D is a significant health concern in NZ, particularly among M\u0101ori and Pacific adults. Characterised by prolonged hyperglycaemia, T2D is generally a progressive condition requiring long-term care.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1463423624000264_as3\">\n\t    <jats:title>Methods:<\/jats:title>\n\t    <jats:p>Semi-structured interviews were conducted between July and December 2022 with 21 primary care clinicians (10 GPs and 11 nurses\/nurse prescribers) from nine different general practice clinics across the Auckland and Waikato regions of NZ. Framework analysis was conducted to identify common themes in clinicians\u2019 perceptions and experiences with T2D management.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1463423624000264_as4\">\n\t    <jats:title>Findings:<\/jats:title>\n\t    <jats:p>Three themes were identified: health-system factors, new medications, and solution-based approaches. Lack of clinician time, healthcare funding, staff shortages, and burn-out were identified as barriers to T2D management under health-system factors. The two newly funded medications, empagliflozin and dulaglutide, were deemed to be a positive change for T2D care in that they improved patient satisfaction and clinical outcomes, but several clinicians were hesitant to prescribe these medications. Participants suggested that additional education and specialist diabetes support would be helpful to inform optimal medication prescribing and that better use of a multi-disciplinary team (clinical and support staff) could support T2D care by reducing workload, addressing cultural gaps in healthcare delivery, and reducing burnout. An improved primary care work environment, including appropriate professional development to support prescribing of new medications and the value of collaboration with a non-regulated workforce, may be required to facilitate optimal T2D management in primary care. Future research should focus on interventions to increase support for both clinical teams and patients while adopting a culturally appropriate approach to increase patient satisfaction and improve health outcomes.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/s1463423624000264","type":"journal-article","created":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T06:50:21Z","timestamp":1726469421000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":6,"title":["General practitioner and nurse experiences of type 2 diabetes management and prescribing in primary care: a qualitative review following the introduction of funded SGLT2i\/GLP1RA medications in Aotearoa New Zealand"],"prefix":"10.1017","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4278-5451","authenticated-orcid":false,"given":"Kimberley","family":"Norman","sequence":"first","affiliation":[{"name":"Monash University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5902-5622","authenticated-orcid":false,"given":"Sara Tareq","family":"Mustafa","sequence":"additional","affiliation":[{"name":"University of Waikato"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shemana","family":"Cassim","sequence":"additional","affiliation":[{"name":"Massey University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilde","family":"Mullins","sequence":"additional","affiliation":[{"name":"University of Waikato"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Penny","family":"Clark","sequence":"additional","affiliation":[{"name":"Northcare Medical Centre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8312-8525","authenticated-orcid":false,"given":"Rawiri","family":"Keenan","sequence":"additional","affiliation":[{"name":"University of Waikato"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8645-3937","authenticated-orcid":false,"given":"Leanne","family":"Te Karu","sequence":"additional","affiliation":[{"name":"University of Auckland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0043-2423","authenticated-orcid":false,"given":"Rinki","family":"Murphy","sequence":"additional","affiliation":[{"name":"University of Auckland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Paul","sequence":"additional","affiliation":[{"name":"University of Waikato"},{"name":"Te Whatu Ora Health New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Kenealy","sequence":"additional","affiliation":[{"name":"University of Auckland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9661-4669","authenticated-orcid":false,"given":"Lynne","family":"Chepulis","sequence":"additional","affiliation":[{"name":"University of Waikato"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2024,9,16]]},"reference":[{"key":"S1463423624000264_ref6","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-048107"},{"key":"S1463423624000264_ref1","doi-asserted-by":"publisher","DOI":"10.4135\/9781526466037"},{"key":"S1463423624000264_ref49","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20136300"},{"key":"S1463423624000264_ref14","doi-asserted-by":"publisher","DOI":"10.1177\/2235042X20971168"},{"key":"S1463423624000264_ref8","article-title":"\u201cPiki Te Ora\u201d: a qualitative evaluation of type 2 diabetes self-management model in primary care, Proceedings of the New Zealand Society of the Study of Diabetes Annual meeting 2024","author":"Crosswell","year":"2024","journal-title":"New Zealand Medical Journal"},{"key":"S1463423624000264_ref17","unstructured":"Health Navigator New Zealand (2021) Social determinants of health [online]. 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