Factors affecting the self-monitoring of blood glucose levels in Aboriginal patients: findings from a remote community

Objective: Despite self-monitoring of blood glucose (SMBG) being highly recommended it appears that many Aboriginal patients do not conduct SMBG. This study investigated factors affecting SMBG in rural and remote Aboriginal patients. Methods: Two focus groups sessions were conducted with nine diabetic Aboriginal adults (age>18 years) using insulin preparations. Focus group discussions were facilitated by a pharmacist and two Aboriginal researchers. Discussions were audio-recorded and later transcribed verbatim and thematically analyzed to identify enablers and barriers. Results: Participants identified multiple barriers, e.g. access and relevant education to use glucometers and understand readings, poor continuity of care and consistency of advice, lack of comfortable environment, stress and emotions, lack of clear communication between health care providers and patients. Facilitators that encouraged participants to practice SMBG included: knowledge of diabetes and its manifestations; rituals and routines. Conclusions: Health care providers should understand patients’ knowledge of diabetes, challenges with SMBG, and the emotions associated with SMBG and value the role of culturally respectful interaction on patient motivation to conduct SMBG. Implications: Aboriginal patients are often stigmatised and blamed for not looking after their diet and monitoring blood glucose. However, health care providers should understand that there are issues regarding the availability, functionality of glucometers as well as Aboriginal patients’ understandings of blood glucose readings. Therefore, appropriate educational interventions aiming patient awareness and empowerment are needed to improve SMBG.