Physician-patient communication at prescription of an additional oral drug for type 2 diabetes and its links to patient outcomes – New findings from the global IntroDia® study

Authors: Edelman S, Belton A, Down S, Alzaid A, Capehorn M, Gamerman V, Nagel F, Lee J, Emmerson J, Polonsky WH.

Abstract

Aims: To investigate experiences of people with type 2 diabetes (T2DM) at the clinic visit when an additional oral antidiabetes drug (OAD) is prescribed, and how this affects their quality of life, self-management and key outcomes.

Methods: We surveyed adults with T2DM from a large multinational study of patient-physician communication during early T2DM treatment (IntroDia®). We examined their experiences when an additional OAD is prescribed (“add-on”) after initial OAD monotherapy, focusing on 24 key conversational elements, overall patient-perceived communication quality (PPCQ), and associations with current patient-reported outcomes. The links between PPCQ and people’s efforts to delay add-on therapy were also assessed.

Results: 4235 people with T2DM prescribed an additional OAD, or a combination of two, were analysed. Exploratory factor analyses of the conversational elements during add-on yielded three coherent, meaningful factors: Encouraging (Cronbach’s α = 0.62), Collaborative (α = 0.81), and Discouraging (α = 0.81). PPCQ was positively associated with Encouraging (β = +1.252, p < 0.001) and Collaborative (β = +1.206, p < 0.001), but negatively associated with Discouraging (β = -0.895, p < 0.001). Better PPCQ at add-on was associated with less diabetes distress, greater well-being and better self-care at the present time. Approximately 20% of people bargained (two-thirds successfully) with their physician to delay additional medication. Non-bargaining individuals reported significantly better mean PPCQ, diabetes distress, well-being and self-care than those who bargained.

Conclusions: Encouraging and patient-inclusive conversations at add-on moments may improve patient well-being and self-care outcomes. People with T2DM who attempted to delay additional medication reported poorer PPCQ and outcomes.

Source: https://pubmed.ncbi.nlm.nih.gov/30685350/

Share the Post:

BDI Monthly Events

July 9Case Consultation
BDI hosts the San Diego-wide, monthly case consultation meeting (for mental health professionals working in the field of diabetes). Contact us at [email protected] if you are in the greater San Diego area and would like further information about this program.
July 18Grownup T1D
July 18: Time for another T1D meet-up! GrownupT1Ds, a wonderful nonprofit here in southern California, is teaming up with TCOYD and BDI for a special Friday afternoon (3 pm - 6 pm) you won’t want to miss. Dr. Edelman (famed endocrinologist, TCOYD Founder and living with T1D) and Dr. Polonsky (BDI President) will be speaking, and it will be a chance to hang out with other adults with T1D. The event will be held at TCOYD, 5720 Oberlin Drive, Suite 150, San Diego, CA 92121. While the event is free, space is limited, so please RSVP https://grownupt1ds.org/.
August 8-10TCOYD ONE
August 8 – 10. Taking Control of Your Diabetes (TCOYD) will be hosting the in-person ONE event, an amazing weekend experience here in San Diego for more than 500 people with type 1 diabetes and their loved ones. Dr. Polonsky is honored to be one of the presenters, and we will hope to see many of you there. There are still a few spaces left, so if you’d like to know more, please visit: https://tcoyd.org/one-2025/