SAN DIEGO — Only 21% of primary care physicians who were surveyed reported that they are doing “very well” in managing patients with diabetes, and only 9% felt “extremely confident” that adequate educational resources exist to help patients effectively use insulin.
Those are key findings from a written survey of 107 primary care physicians in New York and Detroit who were asked about their diabetes education practices and needs, Melinda Maryniuk, R.N., said at a press briefing during the annual scientific sessions of the American Diabetes Association.
“Physicians are not confident that they have enough resources to help their patients manage diabetes, so we know there's a need,” said Ms. Maryniuk, of the Joslin Diabetes Center, Boston.
The survey also revealed that 28% of physicians “frequently” refer diabetes patients to a diabetes educator or program and 95% reported discussing hemoglobin A1c levels at each patient visit.
However, a phone survey of 278 diabetes patients affiliated with the same primary care offices showed that only 61% of the patients discussed A1c results with their physician during an office visit. In contrast, 84% said that their physician discussed results from blood pressure and cholesterol tests.
Nearly half of the patients (47%) reported that they are “extremely” or “very” confident in their ability to manage their diabetes, and 42% of non-insulin users said they would not be willing to use insulin if recommended by their physician.
The researchers also analyzed results from a written survey of registered nurses, licensed practical nurses, and other clinical staff selected by the primary care physicians to receive an in-service program aimed at improving their knowledge of diabetes. Of the 521 respondents who filled out the survey before they received the training, just 15% reported that they help patients manage diabetes “very well,” and 17% reported being “extremely” satisfied with written materials available for diabetes education. Forty-three percent reported discussing A1c levels with patients at each visit.
The surveys were conducted as part of a 2-year study funded by Aventis Pharmaceuticals. Ms. Maryniuk and her associates developed a diabetes education curriculum that they are sharing with the primary care practices in New York and Detroit in an effort to improve care and design intervention programs. Part of the effort involves having a diabetes educator spend 2 hours with clinical staff, educating them about diabetes and sharing how to effectively communicate with patients.
“This is a very low-cost intervention because it's training the office staff to be a little bit more knowledgeable about diabetes, but it's not bringing in educators to teach patients in the office,” said Ms. Maryniuk, who received the 2005 outstanding educator in diabetes award from the American Diabetes Association. “Ideally we'd like everybody to go to a diabetes educator or a diabetes center, but the first step is just to get [patients] a little more information.”