Implementation of a Structured Diabetes Consultation Model to Facilitate a Person-Centered Approach: Results From a Nationwide Dutch Study

Guy E H M Rutten, Heidi A van Vugt, Inge de Weerdt, Eelco de Koning

Research output: Contribution to journal/periodicalArticleScientificpeer-review


OBJECTIVE: We assessed both from a patient and provider perspective the usefulness and added value of a consultation model that facilitates person-centered diabetes care.

RESEARCH DESIGN AND METHODS: The model consists of 1) inventory of disease and patient-related factors; 2) setting personal goals; 3) choosing treatment; and 4) determination of required care. It was implemented in 47 general practices and 6 hospital outpatient clinics. Providers were trained, and patients were recommended to prepare their visit. All filled out a questionnaire after every consultation. Differences between primary and secondary care practices and between physician-led and nurse-led consultations were analyzed.

RESULTS: Seventy-four physicians and thirty-one nurses participated, reporting on 1,366 consultations with type 2 diabetes patients. According to providers, the model was applicable in 72.4% (nurses 79.3% vs. physicians 68.5%, P < 0.001). Physicians more often had a consultation time <25 min (80.4% vs. 56.9%, P < 0.001). According to providers, two of three patients spoke more than half of the consultation time (outpatient clinics 75.2% vs. general practices 66.6%, P = 0.002; nurses 73.2% vs. physicians 64.4%, P = 0.001). Providers stated that person-related factors often determined treatment goals. Almost all patients (94.4%) reported that they made shared decisions; they felt more involved than before (with physicians 45.1% vs. with nurses 33.6%, P < 0.001) and rated the consultation 8.6 of 10. After physician-led consultations, 52.5% reported that the consultation was better than before (nurse visit 33.7%, P < 0.001).

CONCLUSIONS: A consultation model to facilitate person-centered care seems well applicable and results in more patient involvement, including shared decision making, and is appreciated by a substantial number of patients.

Original languageEnglish
Pages (from-to)688-695
Number of pages8
JournalDiabetes Care
Issue number4
Publication statusPublished - Apr 2018


  • Aged
  • Ambulatory Care Facilities
  • Decision Making
  • Decision Support Techniques
  • Diabetes Mellitus, Type 2/diagnosis
  • Female
  • Health Plan Implementation
  • Humans
  • Male
  • Middle Aged
  • Netherlands
  • Patient Participation
  • Patient-Centered Care/methods
  • Physicians
  • Referral and Consultation/organization & administration
  • Surveys and Questionnaires


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