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DAWN2: Communication vital during diabetes office visits
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PHILADELPHIA — The second Diabetes Attitudes Wishes and Needs Study demonstrates a need for improved diabetes education and support from those who live with the disease, their care givers and health care providers, a group of panelists said here.
“We chose to focus on three specific areas. Those areas are the emotional and psychosocial impact of diabetes, the family with diabetes and the patient/health care practitioner dialogue and any gaps in communication that there might be,” Melissa Magwire, RN, CDE, from Shawnee Mission, Kan., said during a panel discussion at the American Association of Diabetes Educators Annual Meeting and Exhibition.
The second Diabetes Attitudes Wishes and Needs Study (DAWN2) was completed in 17 countries and included 9,000 patients with diabetes (aged 18 years or older; duration of disease >12 months), 2,100 family members or care givers with diabetes and 4,900 health care providers.
Emotional, psychosocial affect
Globally, 45% of individuals with diabetes from 17 countries reported diabetes distress and 14% had depresion, as measured by the WHO 5 Well-Being Index, according to data.
“I think the question of what is depression is a very personal thing and commonly is another issue. But there is no question that any chronic disease is going to cause a decreased quality of life. Particularly with diabetes, there’s so much of a life adjustment that needs to be made,” Stephen A. Brunton, MD, adjunct clinical professor in the department of family medicine at the University of North Carolina, Chapel Hill, said here.
Additionally, patients reported a reduction in physical health (62%), an effect on emotions (46%), finances (44%), leisure (38%), work or study (35%) and relationships with family or friends (21%).
Familial burden
Further global data indicate 35% of family members reported that their loved ones’ diabetes caused a burden on the family, and 40% of family members reported a high diabetes distress score.
Additionally, family members said their loved ones’ diabetes effected their own physical health (27%), reduced their emotional well-being (45%), influenced their finances (35%), leisure (31%), work or study (23%) and relationships with family or friends (20%).
Moreover, 39% said they would like to be involved in their family member’s diabetes care, and 46% said they would like to be involved in helping their family member deal with their feelings about diabetes.
Steven V. Edelman
“I think the most effective and easy fix is to encourage the family members to come into the doctor’s office visit, too. They are the second set of ears; there’s not much face-to-face time these days. Getting the patients and family members involved — letting them ask questions and explaining things they can understand — can go a long way. I think it leads to a productive discussion with the caregiver and interfamily discussion later on,” Steven V. Edelman, MD, Endocrine Today Editorial Board Member and professor of medicine in the division of endocrinology, diabetes and metabolism at the University of California at San Diego, and director of the Diabetes Care Clinic at the VA Medical Center, said.
Gaps in communication
According to data, only 49% of patients globally said their health care provider asked them about what they’ve eaten in the last 12 months. However, individual country scores ranged 27% to 64%, according to data.
In addition, the panelists discussed data demonstrating that only 32% in the health care field had asked patients about their feelings of anxiety or depression. “Interestingly, individual country scores ranged from 15% to 57%,” Magwire said.
Further, only 24% of patients with diabetes reported that health care providers asked them about how diabetes affects their lives. However, 52% of health care providers reported that they did ask their patients how diabetes affected their lives.
Edelman said that patients and providers need to redefine their diabetes office visits.
“I try to really spend some time telling my patients their HbA1c is just a number. [I tell them] ‘You’re not a bad person if it’s high or a good person if it’s low,’” he said. – by Samantha Costa
For more information:
Magwire M. #PT07. Presented at: American Association of Diabetes Educators Annual Meeting and Exhibition; August 7-10; Philadelphia.
Disclosure: This product theater session was sponsored by Novo Nordisk. Brunton and Magwire are paid consultants for Novo Nordisk
Perspective
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Theresa Bastian, RD
I found that as a parent of a child with diabetes and as a registered dietician, DAWN2 confirms some of the thoughts about the disease. It was refreshing to see the empathy coming out of the questions. They were right on target. The health professional never really takes time to ask, ‘How are you feeling; how are you coping?’ I enjoyed this presentation because it’s something health care providers really need to take time to do. Medical students also need to know that balance for when they begin clinical practice. We need to take our patients’ feelings more seriously and encourage patients they are doing what they can to manage their disease.
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