Bruno Linetzky|Dongjie Jiang|Martha M. Funnell|Bradley Curtis|William H. Polonsky
Exploring the role of the patient–physician relationship on insulin adherence and clinical outcomes in type 2 diabetes: Insights from the MOSAIc study
Eli Lilly (United States)|University of Michigan–Ann Arbor|Eli Lilly (United States)|University of California, San Diego
abstract background 2year prospective mosaic multinational observational study assessing insulin use understanding challenges associated progression therapy study investigating whether patient physician health systemrelated factors affect outcomes patients type 2 diabetes t2d baseline subanalysis investigated aspects patientphysician relationship associated diabetesrelated distress insulin adherence glycemic control methods patients t2d taking insulin 3 months recruited primary care specialty practice sites 18 countries physicians provided usual care clinical history recent hba1c values collected patients surveyed regarding perception physician interactions diabetesrelated distress level insulin adherence results analysis population comprised 4341 patients four six domains showed significant relationship total diabetesrelated distress p lt 001 poor insulin adherence associated greater diabetesrelated distress adjusted odds ratio aor 114 95 confidence interval ci 106122 higher discrimination aor 113 95 ci 102127 hurried communication aor 135 95 ci 120153 scores lower explained results score aor 086 95 ci 077097 poor insulin adherence associated 043 increase hba1c whereas 1unit increase total diabetesrelated distress hurried communication scores associated 0171 0145 increase hba1c respectively conclusions patients distressed living t2d dissatisfied aspects interactions physicians exhibited poor insulin adherence perceived physician inattention lack engagement diabetesrelated distress directly affect insulin adherence glycemic control