Diabetes oral medication initiation and intensification: patient views compared with current treatment guidelines.
Diabetes Educ
; 37(1): 78-84, 2011.
Article
em En
| MEDLINE
| ID: mdl-21115980
ABSTRACT
PURPOSE:
The purpose of this study was to compare patient perceptions about medication management with principles underlying American Diabetes Association (ADA) published treatment algorithms.METHODS:
Six focus groups (4 English and 2 Spanish) were conducted with 50 patients with type 2 diabetes. Patients were asked about their prior experiences with initiating and changing oral medicines. They were also shown a medication plan for a hypothetical patient depicting future potential changes to achieve glycemic control. Coded responses were mapped to 3 concepts implicit in the ADA recommended treatment algorithm (1) prescribing medicines to achieve A1c goal is beneficial, (2) medical regimens are generally intensified, and (3) intensification should be timely.RESULTS:
Patient perceptions contrasted markedly with the treatment algorithm (1) most patients had negative perceptions of medication initiation, viewing this event as evidence of personal failure and an increased burden; (2) patients equated medication intensification with increased risk for diabetes-related complications (rather than a step to reduce future risk) and viewed de-escalation as a primary goal; and (3) no patients expressed concerns about delays in medication intensification. Patients responded very favorably to an individualized medication plan depicting future potential changes.CONCLUSIONS:
Patients in this study described a conceptual model for medication therapy that contrasted in critical ways from the principles of current treatment guidelines. Underscoring the key role of patient-provider communication, the results suggest that effective counseling should also include an informed discussion of future medication intensification.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Conhecimentos, Atitudes e Prática em Saúde
/
Diabetes Mellitus Tipo 2
/
Hipoglicemiantes
Tipo de estudo:
Guideline
/
Prognostic_studies
/
Qualitative_research
Limite:
Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Diabetes Educ
Ano de publicação:
2011
Tipo de documento:
Article