Despite the fact that patients with diabetes and their physicians often have the same treatment goals ― positive health outcomes and good quality of life ― patients’ nonadherence to a prescribed treatment plan is often a challenge and a source of frustration for providers. Many patients do not end up following the recommended exercise or diet regimen, and they may not check their blood glucose levels or take their medicines as prescribed.
Barriers to adherence for diabetes are as diverse as the patients who are diagnosed with the disease. In many respects, diabetes is a self-managed disease, and patients must deal with it in the context of their other priorities, health concerns, family and career demands, and goals. They may struggle with one aspect of their diabetes treatment plan yet have other aspects well under control. These patients still fall into the nonadherent category, so it is important to discover what part of the complex circle of diabetes care the patient finds challenging.
Dietary restrictions, physical limitations, activity level, stress, medication adherence, and financial struggles can all contribute to treatment adherence issues. Time can also be a significant factor, as it’s estimated that a person with Type 1 diabetes needs to dedicate four hours per day to managing their condition. Likewise, if you’re a single father who works full-time and has two active kids, you might remember to take your medications every day, but find it difficult to set aside the time to plan and prepare healthy meals.
For diabetes care to succeed, patients must be able to make informed decisions about how they will manage their illness, and they may need help developing a strategy for balancing the competing demands in their lives. Taking time to evaluate what part of diabetes care a patient struggles with will allow the patient to problem solve in a way that doesn’t make them feel like they’ve failed, but instead sets them up for success.
You might begin by asking questions like “What concerns or questions do you have about diabetes or your treatment plan?” “What’s the biggest challenge you have in managing your diabetes?” “How can I help?” Such an approach can help to strengthen your relationship, allowing them to view you, the provider, not only as someone with clinical expertise, but also as a collaborator in helping them achieve their health goals.
From a practitioner’s standpoint, an in-depth conversation about barriers and solutions can be extremely time-consuming. That’s where the CDPHP Care Team can help. Let us know about your patients who need additional support outside of their medical appointments with you. We will work with them to identify and address their barriers to adherence, on a time frame that works for them, and we will keep you in the loop with our conversations and findings.
If you have a patient that could use this extra support, please call us at 1-888-942-3747 to get this wrap-around care in place.