"Patients' understanding is the problem": physicians' views of nonadherence among Arabs with type 2 diabetes

Association between self-perceived consultation time and understanding of the prescribed treatment: An analysis of a national survey in Peru

OBJECTIVE

To assess the relationship between the self-perceived consultation time and the knowledge of the proposed treatment.

METHODS

Secondary data from a 2015 national survey of health services in Peru were analyzed. The self-perceived consultation time was calculated by asking how long it took from when you entered the consultation until you departed. It was then categorized as low, medium, and high. Five self-reported questions were used to construct a knowledge of the prescribed treatment. Adjusted regression models from the Poisson family models were used to evaluate the relationship. We report adjusted prevalence ratios (aPR) with their 95% confidence intervals (95%CI).

RESULTS

A total of 9939 outpatients were analyzed, with 58% women; the average age was 44 years; and 45.4% had higher education. Using low self-perceived consultation time as references, medium and high consultation times were associated with understanding the prescribed treatment (aPR=1.17; 95%CI, 1.04-1.33 and aPR=1.30; 95%CI, 1.20-1.40, respectively).

CONCLUSION

Patients who reported a medium and high self-perceived consultation time better understood the prescribed treatment.

IMPLICATIONS FOR PRACTICE

Healthcare professionals should strive to maximize consultation time to ensure effective communication and improve patient knowledge of treatments, improving overall patient satisfaction and health outcomes.

Experiences of barriers to self-monitoring and medication-management among Indian patients with type 2 diabetes, their primary family-members and physicians

OBJECTIVES

This study explored the subjective accounts of the main barriers to self-monitoring of blood-glucose (SMBG) and medication-management among Indian patients with type 2 diabetes (T2DM), their primary family-members (PFMs) and physicians.

METHODS

Using convenience sampling, patients with T2DM, their PFMs, and physicians, residing in a South Indian capital city, were recruited for semi-structured, audio-recorded interviews. Thematic analysis was used to analyze the data.

RESULTS

Fifty patients (female = 14; mean age = 42.5 years) and their PFMs (female = 38; mean age = 39 years), and 25 physicians (female = 4; mean age = 49.8 years) were recruited. Three superordinate themes were identified: (i) complex medication-regimen: confusion, forgetting and reduced motivation, (ii) family recommendations of alternative therapies due to the social pressures of avoiding stigma, intrusiveness and being misrepresented for injecting insulin, and (iii) an expensive illness: choosing to spend money on only medication.

DISCUSSION

Implications of the findings highlight the need to (i) train physicians in communication and empathy skills, (ii) empower patients to communicate their barriers to physicians through triadic communication models and question-prompt lists, (iii) educate communities on the benefits of insulin for managing T2DM to reduce stigma, and (iv) equip communities with information about health insurance to address the financial toll of T2DM management.