Study and year published (continent)	Study aims	Data collection method	Inclusion criteria	Participants	Clinical targets studied
Lee30 2012 (Asia) Note: Lee 2012 and Lee 2014 report different data from the same study	To identify barriers to insulin initiation from the healthcare professionals’ perspective	Focus groups and interviews	Healthcare professionals providing diabetes care and involved in insulin initiation in 3 primary care healthcare settings in Malaysia	38 healthcare professionals, 28 of whom were identified as primary care physicians	Glycaemic control: initiation of insulin
Lee31 2014 (Asia) Note: Lee 2012 and Lee 2014 report different data from the same study	To explore how healthcare professionals assess patients when initiating insulin therapy in type 2 diabetes	Semi-structured interviews and focus groups	Healthcare professionals and other stakeholders who were involved in insulin initiation in primary and secondary care	36 healthcare professionals (12 family physicians; 10 family medicine specialists; 8 medical officers; 3 diabetes nurse educators; 2 endocrinologists; 1 pharmacist); and 5 government policymakers.	Glycaemic control: initiation of insulin
Greaves43 2003 (Europe; UK)	To explore the views of primary care nurses about converting patients with diabetes from oral hyperglycaemic [sic] agents to injected insulin within primary care	Semi-structured interviews	Primary care nurses with responsibility for diabetes care	25 primary care nurses, 18 of these from a diabetes special interest group. Years qualified 27.2 (SD 6.8; range 13–39); years as practice nurse 12 (5.8; 4–25)	Glycaemic control: initiation of insulin
Noor Abdulhadi32 2013 (Asia)	To explore primary healthcare providers’ experience of encounters with patients with type 2 diabetes mellitus and their preferences and suggestions for future improvement of diabetes care	Semi-structured interviews	Primary care physicians and nurses working at a primary healthcare centre who had participated in an observational study	19 primary care physicians and 7 primary care nurses; age range 25–55 years	General
Agarwal33 2008 (North America)	To explore the process and rationale for prescribing decisions of primary care physicians when treating older patients with type 2 diabetes	Interviews	Primary care physicians actively practising within a 1-hour drive of a large suburban city in Ontario, Canada	21 primary care physicians	Glycaemic control: prescribing insulin
Pooley34 2001 (Europe; UK)	To explore the issues that patients and doctors perceive as central to effective management of diabetes with particular attention to the nature of the patient–practitioner relationship	Interviews	Health professionals: from 4 localities within 2 health authorities in North West England, UK, who had signalled their willingness to participate on a previous questionnaire	Healthcare professionals: 7 primary care physicians, 9 primary care nurses, 9 diabetes nurse specialists, 3 community nurses, 5 dieticians, 4 chiropodists, 3 optometrists, 2 diabetes specialist physicians	General
Brown47 2002 (North America)	To explore primary care physicians’ perceptions of the barriers and facilitators to the management of patients with type 2 diabetes mellitus	Focus groups	Primary care physicians participating in simultaneous quantitative study on the management of type 2 diabetes mellitus	30 primary care physicians; age not recorded but average years since graduation 18.7 (range 4–35); sex (M:F) 16:14	General
Stewart35 2006 (Europe; UK)	To explore whether and how practice nurses discuss blood pressure targets and beliefs about the barriers to achieving target blood pressure in patients with diabetes	Semi-structured interviews	Primary care nurses responsible for providing most of the diabetes care in practices taking part in a trial to improve blood pressure in type 2 diabetes mellitus patients in Nottingham, UK	43 primary care nurses	Blood pressure
Howard36 2006 (North America)	To investigate the factors that influence the management of hypertension in patients with type 2 diabetes	Interviews (for qualitative element)	Physicians and patients from 2 primary care medical centres in Halifax, Canada	5 primary care physicians (and 7 patients)	Blood pressure
Crosson37 2010 (North America)	To explore what primary care physicians perceive to be barriers to good cardiovascular disease risk factor control in those with diabetes and hypertension and high cholesterol	Interviews	Primary care physicians in 4 states in US caring for patients with diabetes in a variety of practice environments (solo, group practice, integrated healthcare delivery system)	34 primary care physicians	General: with an interest in cardiovascular disease risk factor control
Ab38 2009 (Europe; non-UK)	To determine factors underlying primary care physicians’ decisions not to prescribe lipid-lowering drugs to patients with type 2 diabetes	Semi-structured interviews	Primary care physicians in a region of the north of the Netherlands, where a guideline on the use of statins in diabetes had been distributed, who indicated they were familiar with the guideline	7 primary care physicians	Cholesterol control: prescribing lipid-lowering drugs
Haque39 2005 (Africa)	To examine barriers to initiating insulin therapy in patients with poorly controlled type 2 diabetes on maximum oral glucose-lowering agents	Focus groups and semi-structured interviews	Primary care physicians at one community health centre in the Western Cape	46 primary care physicians working at 4 primary care community health centres in Cape Town district	Glycaemic control: initiation of insulin
Larme40 1998 (North America)	To explore how attitudes rather than knowledge may impede primary care providers’ adherence to standards of care in diabetes	Interviews (for qualitative element)	Primary care providers attending a continuing medical education programme on diabetes	31 healthcare professionals: 24 primary care physicians, 2 primary care nurses, and 5 physician assistants; age range 27–58 years; sex (M:F) 23:8	General
Fhärm46 2009 (Europe; non-UK)	To explore primary care physicians’ experiences regarding treatment practice in type 2 diabetes with specific focus on the prevention of cardiovascular disease	Focus groups	Experienced primary care physicians from the County of Västerbotten, Sweden, with patients with type 2 diabetes in their practice	14 primary care physicians from 9 group practices; sex (M:F) 6:8; age median 54 years, range 43–64; years since medical degree 24 (10–36); rural:urban practice 5:9	General: with an interest in the prevention of cardiovascular disease
Abbott41 2007 (Europe; UK)	To examine the perceived purposes and functions of self-testing (self-monitoring of blood glucose) as understood by nurses who treat/manage type 2 diabetes in primary care settings	Semi-structured interviews	Nurses working in community and primary care in Essex, UK	7 nurses	Glycaemic control: self-monitoring of blood glucose
Jeavons42 2006 (Europe; UK)	To investigate doctors' and nurses' views about treating patients with type 2 diabetes with unacceptable glycaemic control receiving maximal oral treatment	Focus groups	One primary care physician from each practice in the local health authority; all primary care physician trainers with the local training scheme; and one practice nurse from each practice attending meetings as part of a local practice nurse support group	15 primary care physicians, 8 primary care nurses. Years qualified: physicians 12–41; nurses 6–28. Sex: physicians (M:F) 11:4; nurses 0:8	Glycaemic control: initiation of insulin
Wens45 2005 (Europe; non-UK)	To identify primary care physicians’ thoughts and feelings about type 2 diabetes patients’ adherence to treatment	Focus groups	All primary care physicians in one Belgian municipality	40 primary care physicians; mean age 45.3 years (10.5 SD); sex (M:F) 26:14	General
Burden44 2007 (Europe; UK)	To measure the attitudes of patients, primary care physicians, and nurses when starting insulin in people with type 2 diabetes in primary care	Focus groups followed by plenary session and interviews	For qualitative element: primary care physicians and nurses in two cohorts who completed the Insulin for Life training course on initiating insulin	37 primary care physicians and nurses (numbers of each not specified)	Glycaemic control: initiation of insulin
Alberti49 2007 (Africa)	To discover the main barriers and facilitators to care in the management of diabetes in primary care in a low/middle income country	Observation, focus groups, and interviews	Health professionals (including physicians and nurses) providing diabetes care in public sector primary care centres in Tunisia and patients with diabetes	3 health centres: staff and patients (observation); lead physician plus 7 key informants (interview); 4 paramedical staff groups and 12 patient groups (focus groups); also visits to 48 other health centres; attendees at 19 meetings; and discussions with staff in government departments	General
Daniels48 2000 (Africa)	To audit the responses of health professionals in primary care to receipt of diabetes and hypertension guidelines and to determine their attitudes to implementation	Focus groups and in-depth discussions at first site; semi-structured interviews at other 3 sites; and clinical observation at 3 sites	Healthcare professionals working at community health centres in the Western Cape	15 physicians and 10 nurses at 4 community health centres	General
Grant50 2009 (North America)	To assess whether patient or physician demographic variables influence the decision to intensify therapy in patients with type 2 diabetes	Structured interviews (for qualitative element of study)	Primary care physicians active in clinical care more than half the time and practising in New Jersey, New York, or Pennsylvania, with 12 years or 22 years clinical experience and trained in accredited US medical schools	192 primary care physicians	General: with an interest in medication intensification
Halifax60 2007 (North America)	To review telemedicine as it pertains to hypertension management and to outline experiences in developing a new telemedicine system	Focus groups	Primary care physicians with active clinical practice with English-speaking patients who had type 2 diabetes and hypertension	24 primary care physicians	Blood pressure
Kern52 2001 (North America)	To explore primary care providers' perceived barriers to the delivery of diabetes care	Semi-structured interviews	Primary care physicians from practices with a relatively high proportion of patients with diabetes	12 primary care physicians	General
Kirsh62 2010 (North America)	To identify best practices in outpatient diabetes and the factors associated with their development	Telephone interviews	Primary care diabetes clinic sites	One or more informant/s from each of 31 sites: primary care clinic directors; primary care physicians and nurse practitioners; nurse managers; and clinical pharmacists	General
Loewe61 2000 (North America)	To explore the different frames or explanatory models that physicians and patients use to understand diabetes	Semi-structured interviews and participant observation	Healthcare professionals and patients with diabetes at 1 of 2 family practice training sites in Chicago, US	17 healthcare professionals: 12 primary care physicians; others: 1 medical student, 1 physician assistant, 3 attending physicians (and 22 patients with diabetes)	General
Raaijmakers51 2013 (Europe; non-UK)	To investigate the facilitating and impeding factors among healthcare professionals in diabetes care	Semi-structured interviews	Healthcare professionals with a primary role in diabetes care	18 healthcare professionals in total comprising: 3 primary care physicians, 3 primary care nurses, 1 primary care diabetes nurse (others: non-primary care diabetes nurse, dieticians, physical therapists, internal medicine physicians, pharmacist). Of all 18: mean age 44 years (range 31–59); sex (M:F) 7:11	General
Trewin56 1999 (Europe; UK)	To investigate a suite of presumed influences on primary care physician prescribing practice	Structured interviews	Primary care physicians working in Devon in UK	20 primary care physicians	Glycaemic control
Manski-Nankervis57 2014 (Australia and Oceania)	To explore roles and relationships between health professionals involved in insulin initiation	Interviews (face-to-face and by telephone)	Purposely selected from responders to previous survey in Australia in which relational coordination between health professionals involved in insulin initiation was measured	21 healthcare professionals: 5 primary care physicians; 5 primary care nurses; 5 diabetes nurse educators; 6 hospital physicians	Glycaemic control: initiation of insulin
Tan58 2011 (Asia)	To determine the issues relating to insulin initiation for patients with diabetes managed in primary care polyclinics in Singapore	Focus groups	Physicians and nurses working in primary care polyclinics in Singapore and patients with type 2 diabetes mellitus	8 physicians; 10 nurses; and 11 patients	Glycaemic control: initiation of insulin
Furler59 2011 (Australia and Oceania)	To explore the views of family physicians, diabetes nurse educators, and patients about starting insulin in primary care	Semi-structured interviews	Primary care physicians, diabetes nurse educators with experience of primary care, and patients who had recently commenced insulin or on maximum oral therapy	10 family physicians; 4 diabetes nurse educators; and 12 patients	Glycaemic control: initiation of insulin
Elliott53 2011 (North America)	To identify the systemic barriers to primary care diabetes management in the small office setting in Delaware	Focus groups	Primary care physicians in Delaware	25 physicians: 21 primary care physicians and 4 specialists with an interest in primary care management of diabetes	General
O’Connor54 2013 (Europe; non-UK)	To explore family physicians’ and practice nurses’ perceptions of barriers and facilitators to the proposed transfer of diabetes care to general practice	Focus groups	Practising family physicians and practice nurses in Limerick city and county in Ireland	55 family physicians and 11 practice nurses	General
McHugh55 2013 (Europe; non-UK)	To examine the barriers to, and facilitators in, improving diabetes management from the general practice perspective	Interviews	Family physicians working in Ireland who had opted in during a preceding postal survey on the organisation of diabetes care	31 family physicians	General