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Patient Work and Treatment Burden in Type 2 Diabetes: A Mixed-Methods Study
Gabriela Spencer-Bonilla1, Valentina Serrano2, Catherine Gao3,4
1Department of Medicine, Stanford University School of Medicine, Stanford, CA.
Summary
Patients with type 2 diabetes mellitus (T2DM) find negotiating healthcare services and administrative tasks most burdensome, not necessarily the most time-consuming. Reducing these tasks can minimize disruption to patients' lives.
Area of Science:
- Endocrinology and Metabolism
- Health Services Research
- Patient-Reported Outcomes
Background:
- Type 2 diabetes mellitus (T2DM) management requires significant patient self-care and interaction with the healthcare system.
- Understanding the patient's perspective on treatment burden is crucial for effective diabetes management.
- Previous research has not fully characterized the 'work' patients with T2DM perform and its impact on their lives.
Purpose of the Study:
- To quantitatively and qualitatively characterize the daily work and self-management tasks undertaken by patients with T2DM.
- To explore the interplay between illness, treatment demands, and the overall life experience of individuals with T2DM.
- To identify specific aspects of diabetes care that contribute most significantly to patient treatment burden.
Main Methods:
- A mixed-methods, descriptive study involving adult patients with T2DM at a Mayo Clinic outpatient diabetes clinic.
- Phase 1: Quantified treatment burden using the Patient Experience with Treatment and Self-management (PETS) scale.
- Phase 2: Utilized a smartphone application for real-time data collection on self-management tasks and digital photographs.
- Phase 3: Conducted qualitative interviews analyzed via deductive analysis to explore patient experiences in depth.
Main Results:
- Highest reported treatment burdens included navigating health services, managing medical expenses, and mental/physical exhaustion from self-care.
- Patients spent approximately 2.5 hours daily on medical appointments and 45 minutes on administrative healthcare tasks.
- The perceived burden of a task did not consistently correlate with the time dedicated to its completion.
Conclusions:
- Negotiating healthcare services, affording medications, and administrative tasks represent the most burdensome aspects of T2DM management for patients.
- These high-burden tasks are not always the most time-consuming activities.
- To minimize disruption, diabetes care strategies should focus on reducing the delegation of administrative tasks to patients.
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