Primary healthcare professionals’ awareness of management guidelines for type-2 diabetes mellitus and erectile dysfunction in Indonesia: a focus group discussion during the COVID-19 pandemic

Indonesia's national health system recognizes the interconnectedness of Type-2 diabetes mellitus (T2DM), erectile dysfunction (ED), and cardiovascular consequences; thus, it incorporates ED screening as a recommended practice within its national guidelines for T2DM management. However, a notable gap persists concerning the interpretation and application of the guidelines by healthcare professionals (HCPs) within public primary care settings. This study explored the HCPs’ awareness of the Indonesia’s national guidelines for T2DM management and its influence on their care provision for men with T2DM, particularly those at risk of developing ED. This qualitative study was influenced by Charmaz’s constructivist grounded theory approach, focusing on selectively engaging non-communicable disease management teams from primary care centers in Surabaya, comprising general practitioners, nurses, and nutritionists. The data collection took place during the COVID-19 pandemic through online focus group discussions (FGDs) and was analyzed through open coding, focused coding, and category formation processes. Nineteen HCPs participated in four FGDs. The category “Engaging with T2DM guidelines” emerged, encompassing HCPs’ understanding, adherence, and clinical implication of the recommended T2DM guidelines. A significant barrier identified was the HCPs’ lack of familiarity with the national T2DM management guidelines, primarily due to their release during the COVID-19 pandemic. This hindered their ability to identify ED in patients. Additional challenges, such as demanding daily workloads, unequal distributions of healthcare personnel, and variations in qualifications, further restricted their capacity to stay updated with guidelines and recommended practices. This study identifies a notable lack of awareness among the HCPs regarding the current national guidelines for T2DM management, potentially resulting in inadequate support for addressing the specific needs of men affected by T2DM. Future studies should explore how enhancing HCPs’ skills and knowledge can be effectively translated into the practical implementation of ED screening within T2DM management. Such insights could contribute to optimizing care delivery within Indonesia’s evolving healthcare system.