Patient-reported use of collaborative goal setting and glycemic control among patients with diabetes

Patient Educ Couns. 2013 Jul;92(1):94-9. doi: 10.1016/j.pec.2013.01.016. Epub 2013 Feb 19.

Abstract

Objective: Little is known about how patient-clinician communication leads to better outcomes. Among patients with diabetes, we describe patient-reported use of collaborative goal setting and evaluate whether perceived competency and physician trust mediate the association between collaborative goal setting and glycemic control.

Methods: Data from a patient survey administered in 2008 to a cohort of insured patients aged 18+ years with diabetes who initiated oral mono-therapy between 2000 and 2005 were joined with pharmaceutical claims data for the prior 12 months and laboratory data for the prior and subsequent 12 months (N=1065). A structural equation model (SEM) was used to test mediation models controlling for baseline HbA1c.

Results: The hypothesized mediation model was supported. Patient-reported use of more collaborative goal setting was associated with greater perceived self-management competency and increased level of trust in the physician (p<0.05). In turn, both greater perceived competence and increased trust were associated with increased control (p<0.05).

Conclusions: Findings indicate that engaging patients in collaborative goal setting during clinical encounters has potential to foster a trusting patient-clinician relationship as well as enhance patient perceived competence, thereby improving clinical control.

Practice implications: Fostering collaborative goal setting may yield payoffs in improved clinical outcomes among patients with diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Clinical Competence
  • Communication*
  • Cooperative Behavior
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / drug therapy
  • Diabetes Mellitus / psychology*
  • Diabetes Mellitus / therapy*
  • Female
  • Glycated Hemoglobin A / analysis
  • Goals
  • Humans
  • Male
  • Middle Aged
  • Physician-Patient Relations*
  • Self Care
  • Self Report
  • Trust

Substances

  • Glycated Hemoglobin A