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Better communication of disease-specific and general health information can improve diabetes self-care

Two dimensions of patient-provider communication—diabetes-specific communication and general health communication—are related but distinct facets of the patient-provider relationship, and they both impact the self-care practices of diabetes patients. Although improving both types of communication would be ideal, a recent study has found that diabetes patients enhance their self-care when doctors improve communication of either type. The study was supported in part by the Agency for Healthcare Research and Quality (HS10281) and led by John D. Piette, Ph.D., of the Veterans Affairs Ann Arbor Health Care System and the University of Michigan.

Dr. Piette and his colleagues conducted telephone interviews with 752 adult diabetes patients, who received diabetes care at one of three Veterans Affairs health care systems, one county care system, or one university-based health care system. They asked patients about the type and frequency of diabetes-specific information (for example, diet, exercise, foot care, and medication adherence) and general health information communicated to them by their primary care provider over the past year. They also asked patients about diabetes self-care within the past 7 days. After controlling for other factors, the predicted probability of daily or almost daily foot checks increased from 63 percent for patients who received both poor general communication and poor diabetes-specific communication to 91 percent for those who received the best communication of both types of information.

The predicted probability of taking hypoglycemic medications improved similarly in relation to improved physician communication of both types of information. Patients' predicted probability of following their recommended diet daily increased from 3 percent among patients with poor communication on both dimensions to 28 percent among patients with the best possible combination of communication scores. The probability of daily exercise also increased with better physician communication of either type of information.

Details are in "Dimensions of patient-provider communication and diabetes self-care in an ethnically diverse population," by Dr. Piette, Dean Schillinger, M.D., Michael B. Potter, M.D., and Michele Heisler, M.D., M.P.A., in the August 2003 Journal of General Internal Medicine 18, pp. 624-633.

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