International survey shows quality of patient-physician conversation at diagnosis linked to better patient outcomes

Boehringer IngelheimNew research shows that the quality of patient-physician communication at diagnosis of type 2 diabetes (T2D) may impact future patient self-care and well-being.(1) Data from the IntroDia™ Survey, the largest international survey of its kind, have quantitatively demonstrated this link using responses from more than 10,000 people with T2D across 26 countries.(1,2) A comparable relationship was previously found through IntroDia™ for conversations at the moment when additional oral medication is prescribed (the 'add-on' moment).(2)

"For many, being diagnosed with type 2 diabetes is a stressful and worrying time. People may be anxious because they don’t understand what type 2 diabetes is, or how they will cope. The IntroDia™ results suggest that health professionals can help patients accept and embrace effective diabetes management strategies from the start – just by choosing the right words," explained Anne Belton, Canada, Diabetes Nurse Educator, Vice President of the IDF and member of the IntroDia™ Advisory Panel.

Analyses indicated patients distinguish three types of physician statements that contribute to communication quality: 'encouraging', 'collaborative' and 'discouraging'.(1,2) When physicians used 'encouraging' and 'collaborative' statements, patients’ perception of the communication quality significantly improved.(1,2) Using 'discouraging' statements had the opposite effect.(1,2)

  • 'Encouraging' communication included statements such as: "My doctor told me that a lot can be done to control my diabetes."
  • A 'collaborative' communication example was: "My doctor asked me for my ideas when we made a treatment plan."
  • 'Discouraging' communication included statements like: "My doctor told me that diabetes gets harder to handle over time."

During diagnosis conversations, a fourth type of physician statement was identified, 'recommending other resources', but this was not related to perceived patient conversation quality.(1)

The perceived quality of conversations by patients was linked to all self-reported outcomes surveyed.(1,2) Those who recalled better quality of communication when interacting with their physicians reported improved self-care and well-being, including reduced diabetes-related emotional distress, improved diet and exercise, as well as better medication adherence.(1,2)

Dr William Polonsky, USA, Behavioural Psychologist and member of the IntroDia™ Advisory Panel commented, "IntroDia™ is the largest study of its kind to highlight how effective communication between physicians and people with type 2 diabetes around the world can have a powerful influence on how an individual thinks about and manages their condition. These latest patient data reinforce how important it is for us to get early management right, for the successful long-term management of the disease."

About IntroDia™
IntroDia™ is the largest multi-national survey to date investigating early conversations between physicians and people with T2D. It includes insights from 6,753 physicians and 10,139 people with T2D from 26 countries. The survey focuses on two potentially pivotal time points in T2D management: diagnosis and the 'add-on' moment, when additional oral medication is introduced. Data evaluation is ongoing and further insights will be announced in 2016. The IntroDia™ Survey’s physician insights, coupled with upcoming patient findings, will be used to develop solutions that help shape the early T2D conversations and ultimately improve quality of care.

IntroDia™ is an initiative of Boehringer Ingelheim and Eli Lilly and Company in partnership with the International Diabetes Federation. It has been developed in collaboration with an international, multidisciplinary Advisory Board of T2D experts from the field of primary care, endocrinology, behavioural psychology, nursing and diabetes education including: Ms. Anne Belton, Canada; Dr. William Polonsky, USA; Dr. Steven Edelman, USA; Dr. Matthew S. Capehorn, UK and Ms. Susan Down, UK, Prof. Aus Alzaid, Saudi Arabia.

Survey Design
The IntroDia™ Survey used a combination of validated assessment tools and new research approaches to assess quality of care and identify key elements of physician-patient communication. It was conducted by online questionnaire and with telephone and personal interviews if required.

The data in this release are from the responses of 5,904 people recently diagnosed with T2D from 26 countries, of whom 3,628 people were on one oral anti-diabetic treatment. They were asked about their experiences during consultations, including what their physician said or did.

Patients' perception of the quality of physician communication was assessed through a series of questions including: "Did the doctor explain things in a way you could understand?” and “Did the doctor show respect for what you had to say?"

Boehringer Ingelheim and Eli Lilly and Company
In January 2011, Boehringer Ingelheim and Eli Lilly and Company announced an alliance in diabetes that centres on compounds representing several of the largest diabetes treatment classes. The alliance leverages the strengths of two of the world’s leading pharmaceutical companies. By joining forces, the companies demonstrate commitment in the care of patients with diabetes and stand together to focus on patient needs. Depending on geographies, the companies either co-promote or separately promote the respective molecules each contributed to the alliance.

About Boehringer Ingelheim
The Boehringer Ingelheim group is one of the world’s 20 leading pharmaceutical companies. Headquartered in Ingelheim, Germany, Boehringer Ingelheim operates globally with 146 affiliates and a total of more than 47,700 employees. The focus of the family-owned company, founded in 1885, is researching, developing, manufacturing and marketing new medications of high therapeutic value for human and veterinary medicine.

Social responsibility is an important element of the corporate culture at Boehringer Ingelheim. This includes worldwide involvement in social projects, such as the initiative “Making more Health” and caring for the employees. Respect, equal opportunities and reconciling career and family form the foundation of the mutual cooperation. In everything it does, the company focuses on environmental protection and sustainability.

In 2014, Boehringer Ingelheim achieved net sales of about 13.3 billion euros. R&D expenditure corresponds to 19.9 per cent of its net sales.

About Lilly Diabetes
Lilly has been a global leader in diabetes care since 1923, when we introduced the world's first commercial insulin. Today we are building upon this heritage by working to meet the diverse needs of people with diabetes and those who care for them. Through research and collaboration, a broad and growing product portfolio and a continued determination to provide real solutions - from medicines to support programs and more - we strive to make life better for all those affected by diabetes around the world.

About Eli Lilly and Company
Lilly is a global healthcare leader that unites caring with discovery to make life better for people around the world. We were founded more than a century ago by a man committed to creating high-quality medicines that meet real needs, and today we remain true to that mission in all our work. Across the globe, Lilly employees work to discover and bring life-changing medicines to those who need them, improve the understanding and management of disease, and give back to communities through philanthropy and volunteerism.

1. Polonsky WH, et al. Physician-patient communication at type 2 diabetes diagnosis and its links to physician empathy and patient outcomes: new results from the global IntroDia™ study. Poster A-15-449. 51st Meeting of the European Association for the Study of Diabetes (EASD) 2015, Stockholm, Sweden. 2015.
2. Edelman S, et al. Physician-patient communication at prescription of an additional oral agent for type 2 diabetes: link between conversation elements, physician empathy and patient outcomes. Poster A-15-496 51st Meeting of the European Association for the Study of Diabetes (EASD) 2015, Stockholm, Sweden. 2015.

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