Format

Send to

Choose Destination
Diabetes Res Clin Pract. 2019 Jan 11;148:179-188. doi: 10.1016/j.diabres.2019.01.012. [Epub ahead of print]

Physician experiences when discussing the need for additional oral medication with type 2 diabetes patients: Insights from the cross-national IntroDia® study.

Author information

1
Somerset Partnership NHS Foundation Trust, Parkgate House, East Reach, Taunton, Somerset TA1 3ES, United Kingdom. Electronic address: Su.Down@sompar.nhs.uk.
2
Prince Sultan Military Medical City, PO Box 7897, Riyadh 11159, Saudi Arabia. Electronic address: drausalzaid@hotmail.com.
3
Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; Behavioral Diabetes Institute, 5405 Oberlin Drive, Suite 100, San Diego, CA 92121, USA. Electronic address: whp@behavioraldiabetes.org.
4
The Michener Institute of Education at UHN, 222 St. Patrick Street, Toronto, Ontario M5T 1V4, Canada. Electronic address: ibelton@telus.net.
5
Division of Endocrinology and Metabolism, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; Veterans Affairs Medical Center, 3350 La Jolla Village Dr, San Diego, CA 92161, USA. Electronic address: svedelman@vapop.ucsd.edu.
6
Boehringer Ingelheim Pharmaceuticals, Inc., 900 Ridgebury Road, PO Box 368, Ridgefield, CT 06877, USA. Electronic address: victoria.gamerman@boehringer-ingelheim.com.
7
Boehringer Ingelheim GmbH, Binger Straße 173, D-55216 Ingelheim am Rhein, Germany. Electronic address: friederike.nagel@boehringer-ingelheim.com.
8
Boehringer Ingelheim International GmbH, Binger Straße 173, D-55216 Ingelheim am Rhein, Germany. Electronic address: jisoo.lee@boehringer-ingelheim.com.
9
Boehringer Ingelheim International GmbH, Binger Straße 173, D-55216 Ingelheim am Rhein, Germany. Electronic address: james.emmerson@boehringer-ingelheim.com.
10
Rotherham Institute for Obesity, and Clifton Medical Centre, Doncaster Gate, Rotherham, South Yorkshire S65 1DA, United Kingdom. Electronic address: mcapehorn@yahoo.co.uk.

Abstract

AIMS:

Physician-patient communication when discussing the need for additional oral medication for type 2 diabetes (add-on) may affect the self-care of people with this condition. We aimed to investigate physicians' recalled experiences of the add-on consultation.

METHODS:

We conducted a cross-sectional survey of physicians treating people with type 2 diabetes in 26 countries, as part of a large cross-national study of physician-patient communication during early treatment of type 2 diabetes (IntroDia®). The survey battery included novel questions about physician experiences at add-on and the Jefferson Scale of Physician Empathy.

RESULTS:

Of 9247 eligible physicians, 6753 responded (73.0% response rate). Most (82%) agreed that physician-patient discussions at add-on strongly influence patients' disease acceptance and treatment adherence. Half the physicians reported ≥1 challenge in most or all add-on conversations, with a significant inverse relationship between frequency of challenges and Jefferson Scale of Physician Empathy score (standardised β coefficient: -0.313; p < 0.001). Physicians estimated that only around half their patients with type 2 diabetes follow their self-care advice. Exploratory factor analysis of physician beliefs about why their patients did not follow recommendations yielded two distinct dimensions: psychosocial barriers (e.g. depressed mood) and personal failings of the patient (e.g. not enough willpower) (r = 0.37, p < 0.001).

CONCLUSIONS:

Physicians' empathy and beliefs about their patients may play a significant role in their success with the add-on conversation and, consequently, promotion of patient engagement and self-care. Although the study was limited by its retrospective, cross-sectional nature, the findings from IntroDia® may inform efforts to improve diabetes care.

KEYWORDS:

Patient survey; Patient-reported outcomes; Physician-patient communication; Psychological well-being; Type 2 diabetes

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center