DOC News August 1, 2007
Volume 4 Number 8 p. 10
© 2007 American Diabetes Association
Qualitative Factors Prove Important in Prescription Decisions
Although care for diabetes focuses on treatment targets based on measurable
values, doctors often prescribe medication using less objective criteria,
according to a recent study.
Researchers surveyed academic internists belonging to the American Society
of General Internal Medicine and endocrinologists who are members of the
American Diabetes Association. All of the 886 clinicians surveyed provide
clinical services to people with type 2
diabetes.
The survey asked participants to weigh the importance of 15 patient,
physician, and nonclinical factors related to decisions about initial patient
management, second-line agents, and insulin.
Among the factors physicians most often cited as affecting their treatment
decisions were the patient's medical condition, glycated hemoglobin (A1C)
level, and adherence to drug therapy. Regarding insulin treatment decisions,
survey respondents said they frequently considered patients' needle fears.
Overall, qualitative issues such as patient adherence with drug therapy and
motivation to comply with treatment tended to carry more weight than
quantitative factors such as weight or A1C level.
Grant RW, Wexler DJ, Watson AJ, et al.: How doctors choose
medications to treat type 2 diabetes. Diabetes Care 30: 1448-1453, 2007.[Abstract/Free Full Text]
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