Physicians' and patients' views of problems of compliance with diabetes regimens

Thirty noninsulin-dependent diabetic patients and 30 residents in internal medicine at Cleveland Metropolitan General Hospital were surveyed regarding their perceptions of the difficulties of complying with diabetic regimens. Three main components of compliance were investigated (medication, diet, and urine testing), and each component was broken down into three separate tasks. Physicians and patients rated the components on a scale of 0 to 10. For each of the three components, physicians rated compliance tasks as more difficult than did the patients. In addition, statistically significant differences were found in the difficulty ratings given separate tasks within each component of compliance. Finally, a statistically significant interaction reflected differences in difficulty ratings of patients compared with those of physicians for the various tasks associated with dietary compliance. Results indicated that physicians and diabetic patients differ in their perceptions of compliance difficulties. It would appear that either physicians were overestimating the difficulty that diabetic patients experience with various tasks or that patients underestimated (or underreported) their difficulty. Possible sources of these differences and their implications for patient and physician education are discussed.