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Diabetes management improves when patients, doctors agree on treatment goals, UMHS study finds

em is that providers are not explicitly talking with patients about overall treatment goals and what strategies to prioritize. There is often more than one treatment goal that might make sense to target at any given time, which is why it's so important to set priorities," says Heisler, who is also an investigator at the Ann Arbor Veterans Affairs Center of Excellence.

In the study, patients who agreed with their doctors on more treatment goals reported being more confident about managing their diabetes and more successful at their self-management than patients with less agreement.

The findings can be extrapolated to include people with other chronic health conditions in which patients must monitor their health and often make and sustain difficult behavioral changes such as a strict diet or exercise regimen including coronary artery disease, congestive heart disease, arthritis or chronic obstructive pulmonary disorder.

The key, Heisler says, is for patients to understand their condition and be aware of treatment options. From there, they should think through what health goals are most important to them and what strategies fit into their lifestyle. Above all, Heisler says, don't be afraid to raise questions or concerns with your doctor.

"Doctors are used to telling patients what they should do, often without giving very much information or being aware of the obstacles patients may face. We say, 'you should exercise more' or 'eat fewer fatty foods and sweets' without exploring patients' values and health priorities and without helping patients think of specific ways to achieve this. So when doctors just give short instructions, patients could take the initiative," Heisler says.

She also suggests patients tell their doctors some of the concrete steps they plan to take toward achieving health goals. Often, the doctor may have other helpful suggestions. On the flip side, patients also need to tell doctors when something is not wor
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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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