Key Themes to Care for Patients With Type 2 Diabetes and HIV/AIDS Comorbidities, Soweto, South Africa

ThemeExpectationsWorkingNot Working
Organizational—Care pathways and referral systemMultidisciplinary team working together to manage patients with comorbiditiesMost patients are referred to a tertiary hospital. Most go through the medical outpatient clinic before they are referred to specialty clinics.Limited collaboration among providers due to poor communication, staff shortage, lack of resources, and so forth.
Managing patients with type 2 diabetes and HIV/AIDS comorbiditiesEfficient communication, electronic health record systemCommunication is mostly done manually through a patient's file. Diabetes/endocrine clinic has implemented electronic system that captures patients' biometric data.Due to workload and staff shortage, rarely do health providers communicate with colleagues, especially when they are in different buildings. Most other clinics use manual data capture in patient's files. Having noncentralized patient records further challenges proper communication.
Patient support and involvement of family members or caregivers in care.Fully involve patients and their family/caregivers in care or decision making.Mostly, patient are supported in group forums, such as during diabetes education sessions. Social workers visited patients at home.Doctors rarely involved patients or caregivers in health care. Patient were supported in groups rather than individually. Some caregivers failed to collaborate with social workers during home visits.