Overwhelmed patients

A videographic analysis of how patients with type 2 diabetes and clinicians articulate and address treatment burden during clinical encounters

Krista Bohlen, Elizabeth Scoville, Nathan D. Shippee, Carl R. May, Victor Manuel Montori

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

OBJECTIVE - Patients with diabetes may experience high burden of treatment (BOT), including treatment-related effects and self-care demands. We examined whether patients with type 2 diabetes and their clinicians discuss BOT, the characteristics of their discussions, and their attempts to address BOT during visits. RESEARCH DESIGNANDMETHODS - Two coders independently reviewed videos of 46 primary care visits obtained during a practice-based trial and identified utterances concerning BOT, classifying them by topic and by whether BOT was addressed (i.e., whether statements emerged aimed at alleviating BOT). RESULTS - Of the 46 visits, 43 (93.5%) contained BOT discussions. 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. CONCLUSIONS - BOT discussions usually arise during visits but rarely beget problem-solving efforts. These discussions representmissed opportunities for reducing treatment-related disruptions in the lives of patients with diabetes, which may affect adherence and well-being.

Original languageEnglish (US)
Pages (from-to)47-49
Number of pages3
JournalDiabetes Care
Volume35
Issue number1
DOIs
StatePublished - Jan 2012

Fingerprint

Type 2 Diabetes Mellitus
Therapeutics
Self Care
Primary Health Care

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Overwhelmed patients : A videographic analysis of how patients with type 2 diabetes and clinicians articulate and address treatment burden during clinical encounters. / Bohlen, Krista; Scoville, Elizabeth; Shippee, Nathan D.; May, Carl R.; Montori, Victor Manuel.

In: Diabetes Care, Vol. 35, No. 1, 01.2012, p. 47-49.

Research output: Contribution to journalArticle

@article{33c99d08a00e44cb9abba50b7c7c81a3,
title = "Overwhelmed patients: A videographic analysis of how patients with type 2 diabetes and clinicians articulate and address treatment burden during clinical encounters",
abstract = "OBJECTIVE - Patients with diabetes may experience high burden of treatment (BOT), including treatment-related effects and self-care demands. We examined whether patients with type 2 diabetes and their clinicians discuss BOT, the characteristics of their discussions, and their attempts to address BOT during visits. RESEARCH DESIGNANDMETHODS - Two coders independently reviewed videos of 46 primary care visits obtained during a practice-based trial and identified utterances concerning BOT, classifying them by topic and by whether BOT was addressed (i.e., whether statements emerged aimed at alleviating BOT). RESULTS - Of the 46 visits, 43 (93.5{\%}) contained BOT discussions. 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. CONCLUSIONS - BOT discussions usually arise during visits but rarely beget problem-solving efforts. These discussions representmissed opportunities for reducing treatment-related disruptions in the lives of patients with diabetes, which may affect adherence and well-being.",
author = "Krista Bohlen and Elizabeth Scoville and Shippee, {Nathan D.} and May, {Carl R.} and Montori, {Victor Manuel}",
year = "2012",
month = "1",
doi = "10.2337/dc11-1082",
language = "English (US)",
volume = "35",
pages = "47--49",
journal = "Diabetes Care",
issn = "1935-5548",
publisher = "American Diabetes Association Inc.",
number = "1",

}

TY - JOUR

T1 - Overwhelmed patients

T2 - A videographic analysis of how patients with type 2 diabetes and clinicians articulate and address treatment burden during clinical encounters

AU - Bohlen, Krista

AU - Scoville, Elizabeth

AU - Shippee, Nathan D.

AU - May, Carl R.

AU - Montori, Victor Manuel

PY - 2012/1

Y1 - 2012/1

N2 - OBJECTIVE - Patients with diabetes may experience high burden of treatment (BOT), including treatment-related effects and self-care demands. We examined whether patients with type 2 diabetes and their clinicians discuss BOT, the characteristics of their discussions, and their attempts to address BOT during visits. RESEARCH DESIGNANDMETHODS - Two coders independently reviewed videos of 46 primary care visits obtained during a practice-based trial and identified utterances concerning BOT, classifying them by topic and by whether BOT was addressed (i.e., whether statements emerged aimed at alleviating BOT). RESULTS - Of the 46 visits, 43 (93.5%) contained BOT discussions. 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. CONCLUSIONS - BOT discussions usually arise during visits but rarely beget problem-solving efforts. These discussions representmissed opportunities for reducing treatment-related disruptions in the lives of patients with diabetes, which may affect adherence and well-being.

AB - OBJECTIVE - Patients with diabetes may experience high burden of treatment (BOT), including treatment-related effects and self-care demands. We examined whether patients with type 2 diabetes and their clinicians discuss BOT, the characteristics of their discussions, and their attempts to address BOT during visits. RESEARCH DESIGNANDMETHODS - Two coders independently reviewed videos of 46 primary care visits obtained during a practice-based trial and identified utterances concerning BOT, classifying them by topic and by whether BOT was addressed (i.e., whether statements emerged aimed at alleviating BOT). RESULTS - Of the 46 visits, 43 (93.5%) contained BOT discussions. 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. CONCLUSIONS - BOT discussions usually arise during visits but rarely beget problem-solving efforts. These discussions representmissed opportunities for reducing treatment-related disruptions in the lives of patients with diabetes, which may affect adherence and well-being.

UR - http://www.scopus.com/inward/record.url?scp=84859062014&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84859062014&partnerID=8YFLogxK

U2 - 10.2337/dc11-1082

DO - 10.2337/dc11-1082

M3 - Article

VL - 35

SP - 47

EP - 49

JO - Diabetes Care

JF - Diabetes Care

SN - 1935-5548

IS - 1

ER -