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Burden of Treatment in Diabetes Rarely Addressed
Chances to offer options to improve adherence, satisfaction often missed in office visits

WEDNESDAY, Jan. 4 (HealthDay News) -- Although the burden of diabetes treatments is discussed in more than 90 percent of primary care office visits, problem-solving efforts are made in only about one-third of cases, according to a study published in the January issue of Diabetes Care.

Krista Bohlen, Pharm.D., of the Mayo Clinic in Rochester, Minn., and colleagues used videographic analysis to evaluate whether patients with type 2 diabetes participating in a clinical trial discussed the high burden of treatment (BOT) with their clinicians and, if so, how these concerns were addressed. BOT was defined as treatment-related effects that limit the ability to participate in activities and tasks that are crucial to quality of life and that are not attributable to underlying disease. Two raters identified discussions in four separate domains, including access to timely, convenient, or affordable treatment; treatment administration concerns; unwanted or unintended consequences of treatment; and trouble monitoring the safe and effective use of the medication or following its ongoing effects.

The researchers found that, in videographic analysis of 46 primary care office visits, BOT was discussed in 93.5 percent of the visits.


Patients initiated these discussions more than half the time (55 percent). As often as these discussions took place, however, the patient's BOT was only unambiguously addressed in 30 percent of cases, representing missed opportunities to address important issues that can affect patient adherence and satisfaction with diabetes treatments.

"Patients with diabetes routinely discuss BOT with clinicians but often with no effect. In the context of diabetes and other chronic diseases, this represents lost opportunities to offset preventable nonadherence, costs, and poorer quality of life for patients. As we progress toward providing minimally disruptive medicine, clinicians may need education on strategies for discussing and addressing BOT with patients," the authors write.

Physician's Briefing
 

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I suspect that's true for most, if not all, chronic or long-term conditions. It appears that the "take one pill and call me in the morning" model still holds sway. Leaves very little room for guiding patients in living with their conditions, or exploring alternatives that would allow them more quality of life.
 
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Interesting too that the first author is a Pharm.D., not an MD.
 
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It is further estimated that by 2050, one in every three American adults would have developed diabetes and that is why it is important to start educating and informing people of the possible repercussions of a high sugar unhealthy diet.

I just copy and pasted the above information from an article that was on the main page when logging into the diabetes forum. It is an article regarding Walgreens and the ADA. Do these people realize that diabetes isn't just about a high sugar diet? Why do they not include the high carbohydrates? Unbelievable!
 

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I just copy and pasted the above information from an article that was on the main page when logging into the diabetes forum. It is an article regarding Walgreens and the ADA. Do these people realize that diabetes isn't just about a high sugar diet? Why do they not include the high carbohydrates? Unbelievable!
It's very annoying, carbs are just sugar waiting to happen. Why that is not articulated I dont know ?

I will never forget in the beginning , eating my recommended bowl of porridge for breakfast and the meter beeping at me a reading of 324 (18), thinking to myself "I'm not getting very good advice here"
 

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It's very annoying, carbs are just sugar waiting to happen. Why that is not articulated I dont know ?

I will never forget in the beginning , eating my recommended bowl of porridge for breakfast and the meter beeping at me a reading of 324 (18), thinking to myself "I'm not getting very good advice here"
You said it - exactly - something I learned in school 53 years ago! To process starch, the body first turns it to sugar. (1st year chemistry)

When I was diagnosed here in France I had a couple of days at home then had to go back to the hospital. I took a list of what I had eaten over the weekend. (Reduced carbs). I thought I was being helpful and constructive.

The doctor gave me a telling off because there wasn't enough starch in the diet - she even wrote to my (new) GP warning him that she'd had to provide dietary guidance to me as my diet was clearly "not well balanced".

Fortunately my wife is even more stubborn than I am when she knows she's doing the right thing! And I'm very stubborn too!

It's sad but true - there's an awful lot of sick diabetics out there who would not be having the problems they currently have if the establishment would own up to the nonsense they have been pushing for 30 years!

:mad: Rant over - from Disgusted in France.
 

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This is from the linked extract:

Both coders identified 83 discussions: 12 involving monitoring, 28 treatment administration, 19 access, and 24 treatment effects. BOT was unambiguously addressed only 30% of the time.
I find this very interesting.
 
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