Managing the new wave of weight loss medication in general practice: A qualitative study.

In early 2023, a new type of weight loss medication, Wegovy (semaglutide), was made available in Denmark. Both subsequent media coverage and public demand were huge. Wegovy is only available by prescription, primarily via general practitioners. However, there is very little knowledge about how healthcare professionals (HCPs) in general practice might deal with the great demand for and attention surrounding a new weight loss drug. The aim of this qualitative study was, therefore, to explore how Wegovy is managed and negotiated in general practice, particularly in terms of prescribing and follow-up. We conducted a focused ethnography study based on direct observation of consultations and both formal and informal interviews with seven doctors and four nurses from three general practices in Denmark. Using discourse analysis, we identified four central discourses revolving around trust in medicine, individual responsibility for health, the cost of weight loss medication, and the importance of shared decision-making. This study shows that the availability of a new, sought-after weight loss medication presents both opportunities and challenges for HCPs in general practice. The management of Wegovy involves numerous factors, including medical, economic, organizational, interpersonal and moral concerns.

Experiences of young people living with type 1 diabetes in transition to adulthood: The importance of care provider familiarity and support.

BACKGROUND: During the developmental transition from childhood to adulthood, young people living with type 1 diabetes (T1D) are more likely to take less care of their chronic disease. Alongside the developmental transition, young people with T1D also experience an organisational transition in which the care responsibility changes from a family-based approach in paediatric care to an individualised approach in adult care. Little is known from the perspective of the young people about what their interactions with the healthcare providers mean during these transitions. AIM: The aim of this study is to explore how young people living with T1D experience interactions with their care providers, and what it means for their developmental transition. METHOD: Semi-structured interviews with 10 respondents aged 18-20 living with T1D who were recruited from a youth outpatient diabetes clinic in Denmark. Recorded audio data were transcribed and analysed using an interpretative phenomenological analysis approach. RESULTS: Young people experience continuity in the relationship with the diabetes nurse from the paediatric clinic and a personal patient-provider relationship with their well-known and new care providers. This creates a feeling of familiarity and contributes to a seamless transition. The young people express that becoming more involved in diabetes treatment increases their willingness to take more responsibility for their own health. They also express that care providers should support them in managing their diabetes and talk about sensitive topics. CONCLUSION: Continuity in the relationship with the diabetes nurse makes the transition from paediatric to adult care more satisfying and seamless. To support the developmental transition, care providers should gradually involve young people more in diabetes management and be supportive as they become more independent during the developmental transition.

Communication about weight-related issues with adult patients with obesity in general practice: A scoping review.

Background: Primary care providers see patients with obesity in general practice every day but may be challenged regarding communication about obesity. The research question of this study is: how do general practitioners and general practice staff and adult patients with obesity communicate about weight-related issues? Methods: A scoping review approach was used, searching PubMed, Scopus and CINAHL for peer-reviewed studies - of both quantitative and/or qualitative study designs, and published between 2001 and 2021. Results: Twenty articles were included. The weight-related issues discussed were by far physical issues, and only one study mentioned psychosocial issues. Most of the included studies contained information on who initiates the communication, how the weight-related issues are addressed and handled, and also obstacles and challenges in relation to the communication. The studies lacked information of when the weight-related issues are addressed and differences in views and experiences when discussing weight-related issues in general practice. Conclusion: Studies with the main focus communication about obesity and overall health in general practice are needed. Findings also indicate, that non-stigmatizing communication tools and guidelines are needed on this area to promote these types of conservations.

Communication about weight-related issues with patients with obesity.

This review focuses on communication about weight-related issues with patients with obesity in general practice. Primary care providers still lack knowledge and tools to address and communicate about the topic of weight and weight-related issues - with focus on minimizing stigmatization and a person centered approach. A few communication tools on the topic have been developed but it seems that the use of those is limited, suggesting an urgent need for making a fast, easy and simple tool for the use in general practice.