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.