The diabetes annual review in a postal box: a qualitative study exploring views of people with diabetes

People with diabetes who do not attend their annual review appointments often have poorer glycaemic control and increased complication rates. A postal kit for self-collection of blood tests, urine samples, and anthropometric data may facilitate remote annual reviews and improve uptake. To explore views on a postal kit for annual review among people with diabetes and to collaborate with people living with diabetes to design and expand the scope of an annual review postal kit. We conducted semi-structured interviews and focus groups with adults with type 1 and type 2 diabetes. Purposive sampling was used to ensure 50% of study invites went to infrequent attenders of annual review appointments. Transcripts were collated and analysed thematically. Twenty-two participants took part, including nine infrequent attenders. All infrequent attenders and the majority of regular attenders responded positively to a postal kit, with convenience being the most prominent value described. Concerns raised related to personal capability of self-collection and the accuracy of results. Participants were asked for suggestions to improve the kit. The most common themes related to communication; participants wanted clearer information regarding the purpose of each test; they wanted feedback of their results through either a website or app with tailored advice for each result; and they wanted to utilise the kit to communicate their priorities for discussion at future consultations. Postal kits for annual reviews were well-received by people living with diabetes. Designed well, they have the potential to overcome far more than just the physical barriers to annual review attendance.