Challenges and Opportunities in Adapting Patient Navigation in Diabetes Care

Patient navigation has been used frequently and successfully to improve cancer care (screening, diagnosis, treatment and follow-up). However, little is known about its potential effectiveness with other chronic diseases. A formative evaluation was conducted in three sites serving rural and urban patients regarding the need for and practicality of developing a patient navigation program in diabetic care.

Semi-structured interviews and focus groups were conducted to identify gaps in existing clinical practice and potential role for a navigation program. Open-ended interview questions were structured across distinct themes derived from the discussion of our previous Patient Navigator Workshop. Total of 24 participants were interviewed across three sites and numbers of participants per site ranged from 5 to 11. Participants included clinicians, administrators, coordinators, educators, and operation managers. Content analysis was conducted to understand the potential opportunity and challenges to adapting a patient navigation program into diabetic care.

Lack of patient education was the most significant unmet need in managing diabetes. Secondarily, lack of medical insurance and financial need were indicated as a major factor in patient's noncompliance. Navigation could be beneficial in the ongoing monitoring as well as facilitating communication between various providers.

Diabetic patients need continuity of support, monitoring, and resource for compliance and disease management. There is potential for patient navigation in diabetes care, but future research is needed to develop appropriate models.