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Thesis

French

ID: <

10670/1.516b1q

>

Where these data come from
Cooperation between health professionals in primary care for chronic diseases : application to type 2 diabetes

Abstract

The epidemiological transition calls for redefining the roles of the various professionals involved in primary health care towards greater collaboration to bridge the gap between increasing healthcare needs and limited professional resources. Practical modalities and the acceptability of this collaboration in primary care need to be further defined. The aim was to identify general perspectives on factors influencing interprofessional collaboration in primary care and to explore processes of care realised by general practitioners, which could be transferred to other health care professionals, for patients with a prototypic disease. The review on determinants of interprofessional collaboration showed that the skill-mix among primary healthcare teams should consider the views of all involved actors, including the patient, for research, training and care protocols. The principal facilitating factors were the different actors’ common interest in interprofessional collaboration, perceiving opportunities to improve quality of care and to develop new professional fields. The main barriers were the challenges of definition and awareness of one another’s roles and competences. For patients with type 2 diabetes, analyses from the ECOGEN study showed that a significant part of GP activity could be transferred to allied healthcare professionals, provided that cardiovascular risk prevention is properly considered. Task-shifting evolves towards interprofessional collaboration including the patient himself and a global patient perspective. The views of patients and healthcare professionals should be sought before conducting further studies

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