ANN ARBOR, Mich. People with diabetes who agree with their physician's treatment goals and strategies were more likely to be successful at managing their condition, but few patients agree with their doctor's top three goals and strategies, researchers at the University of Michigan Health System report.

"With chronic diseases, the bulk of treatment has to be carried out by patients, at home, between office visits," says lead author Michele Heisler, M.D., MPA, a lecturer in the Department of Internal Medicine at U-M Medical School. "And because there are many different things that have to be done and many tough behavioral changes patients are more likely to be successful if they and their doctors agree on and target specific changes. Besides knowing their medicine, doctors have to be better coaches for their patients."

In the study, to be published in the November issue of the Journal of General Internal Medicine, researchers sent surveys to diabetes patients and their primary care physicians asking both groups to list their top three treatment goals and their top three treatment strategies for that specific patient. Of 127 patient-physician pairs, only 5 percent agreed on the three top treatment goals and 10 percent agreed on all three treatment strategies. Nearly one-fifth of patients and doctors did not overlap on any of their top three treatment goals.

But it's not all grim: Three out of five patients overlapped with their doctor on at least one treatment goal and more than half shared one treatment strategy. Fifty-five percent of patients included their doctor's No. 1 goal and strategy among their top three.

Patients who said they shared responsibility with their doctor for making treatment decisions were more likely to agree with their doctor's top strategies. Similarly, doctors who reported discussing more areas of diabetes self-management with their patients saw more agreement on treatment strategies.

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Contact: Nicole Fawcett
nfawcett@umich.edu
734-764-2220
University of Michigan Health System
8-Nov-2003

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