Discordance between physician and patient perceptions in the treatment of diabetes mellitus: a pilot study of the relationship to adherence and glycemic control.
Glycolsylated hemoglobin (G Hb) levels and data on adherence and patient-provider discordance in beliefs about diabetes were collected from 42 insulin-requiring patients with diabetes. Discordance was calculated for both degree of discordance (absolute amount of disagreement) and direction of discordance (degree to which physician > patient or patient < physician). Patients generally agreed with physicians in perceptions of severity, costs of adherence, and immediate and long-term benefits of adherence. Significant differences were found between these dimensions. Only discordance on long-term benefits of adherence correlated with adherence, with greater discordance related to greater adherence. Discordance on the cost dimension correlated negatively with G Hb, suggesting better glycemic control with greater disagreement. Those who underestimate the cost of adherence show greater adherence. Adherence did not correlate significantly with glycemic control.
Boyer
B A
BA
Lerman
C
C
Shipley
T E
TE
McBrearty
J
J
Quint
A
A
Goren
E
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003220:Conflict, Psychological; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism / Q000523:psychology* / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology* / Q000628:therapy*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008875:Middle Aged; D010349:Patient Compliance; D010817:Physician-Patient Relations; D010865:Pilot Projects; D011795:Surveys and Questionnaires
D006442:Glycated Hemoglobin