Table 1.
Classification of the gaps/barriers identified in the targeted countries/region.
| Country/Region | Type | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Phase of the Continuum of Care | Themes: Gaps and barriers | Austria | Canada | Germany | UK | Knowledge | Skill | Attitude | Behaviour | Context | References |
| Condition | Pathophysiology of diabetes | X | X | X | X | EIMSED-NA | |||||
| Diagnosis | Diagnosis criteria | X | X | X | X | X | AXDEV-NA, BMJ-GAP, [47,48] | ||||
| Pre-diabetes | X | X | X | BMJ-GAP, [43] | |||||||
| Lack of screening | X | X | X | X | AXDEV-NA | ||||||
| Testing | Assessment of treatment targets | X | X | X | X | X | X | AXDEV-NA, BMJ-GAP, [30-32,40,49,50] | |||
| Treatment | Explaining drugs' modes of action | X | X | X | X | X | BMJ-GAP, EIMSED-NA, [48] | ||||
| Decision-making in therapies | X | X | X | X | X | X | X | AXDEV-NA, BMJ-GAP, EIMSED-NA, [48,51-54] | |||
| Treatment guidelines | X | X | X | X | EIMSED-NA, [34,35,55] | ||||||
| Insulin therapy | X | X | X | X | X | X | BMJ-GAP, EIMSED-NA, [36,37,56] | ||||
| Management | Adherence | X | X | X | X | X | X | X | X | AXDEV-NA, EIMSED-NA, [38,39] | |
| Management of complications | X | X | X | X | X | X | X | BMJ-GAP, EIMSED-NA, [41,57-59] | |||
| Lifestyle changes | X | X | X | X | X | AXDEV-NA, BMJ-GAP, [43,44,60] | |||||
| Patient education | X | X | X | X | AXDEV-NA-NA, BMJ-GAP-GAP, [44] | ||||||
| Blood pressure control | X | X | [61] | ||||||||
| Tele-monitoring | X | X | X | [62] | |||||||
| Computerization of management | X | X | X | X | [2] | ||||||
| Psychological care | X | X | X | X | X | X | AXDEV-NA, [63] | ||||
| Motivation for long-term follow-ups | X | X | X | X | AXDEV-NA | ||||||
| Interprofessional teamwork | X | X | X | [48] | |||||||
| Lack of secondary support | X | X | [64] | ||||||||
| Referral | Suboptimal team integration | X | X | X | X | X | X | BMJ-GAP, [45,47,48] | |||
| Context | Bureaucracy | X | X | X | X | X | X | AXDEV-NA, EIMSED-NA | |||
| Long waiting lists | X | X | [65] | ||||||||
| Care for the aboriginal population | X | X | [40] | ||||||||
| Access and cost | X | X | [40,65,66] | ||||||||
| Third party payers | X | X | X | X | EIMSED-NA, [67] | ||||||
| Other | Physicians' resistance to change | X | X | X | [54] | ||||||
| Lack of resources | X | X | [54] | ||||||||
| Physicians' bias towards obesity | X | X | [68] | ||||||||
| Disengagement of patients | X | X | X | AXDEV-NA | |||||||
| Provider-Patient relationships | X | X | X | X | AXDEV-NA | ||||||
Note: Gaps and barriers presented in bold are those that were common in at least 3 of the 4 targeted countries.