Issue 176 Item 2 Poor Doctor/Patient Communication – A Major Cause of Non-Compli

The outcome of diabetes is largely determined by patients’ adherence to medication regimens and lifestyle modifications. However, patient compliance for chronic illnesses such as diabetes is alarmingly low, imposing a considerable financial burden on the modern health care system.

Although a large body of research on the topic of compliance has been reported, most has focused on the doctors’ point of view rather than the patients’.

"Understanding the factors that enable patients to adhere to diabetes treatment is the first step to designing effective interventions," writes Etienne Vermeire, MD, of the University of Antwerp, Belgium. Dr Vermeire and colleagues performed an exploratory study aimed at understanding the health beliefs of patients with type 2 diabetes, the way they communicate about it, and the problems they encounter in adhering to therapeutic regimens.

Seven focus groups were held with a total of 46 patients with type 2 diabetes (25 females) recruited by pharmacists in and around the city of Antwerp. The participants were asked to express their opinions about a number of questions and statements related to diabetes and disease management. Emphasis was given to patients’ opinions regarding illness, health beliefs, communication and barriers to adherence to treatment.

The researchers found that diabetics often receive incomplete information from their doctor, and many patients admitted to having a poor knowledge of the disease. Moreover, doctors often gave conflicting information, and it was not clear to patients whether guidelines for diabetes management even existed. Patients reported that doctors paid too little attention to their health beliefs, and felt that many doctors could not relate to having a chronic disease.

Most patients stated that they did not feel different whether or not they adhered to treatment. Many admitted to testing themselves and adapting their therapy because they did not want to lose contact with their body, and they wanted to know how it functioned without treatment.

Based on the focus group discussions and literature search findings, the researchers suggest that patient compliance is strongly influenced by health beliefs, quality of doctor/patient communication, and the information given to the patient.

"The solution to the waste of resources inherent to non-compliance lies perhaps not in attempting to increase patient compliance per se, but in the development of a more open, cooperative doctor/patient relationship." Prac Diab Int 2003;20:6:209-14

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DID YOU KNOW:
The Diabetes Education Society offers online accredited continuing education programs. Got an hour, take a course. Visit www.MedEdOps.org, take the free sample course and review the Course Catalog. Then update yourself and your staff to meet your Education Recognition requirements. For more information call (800) 659-5808.