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Drug and medical information preferences in a sample of diabetic patients. Diabetes care improvement through evidence based pharmacy

Introduction: Patients may not always have the same perspective of disease and treatment as health-care providers; indeed, attitudes and behaviours towards treatment may affect the outcome of therapy. Studies have shown that satisfaction with the interpersonal quality of the patient-provider relationship is significantly associated with adherence to treatment in diabetes.1 Previous studies have measured patients’ desire for information and have shown associations between this, socio-demographic variables and patient satisfaction.2,3 The aim of this study was to refine and further validate a patient-respondent scale for the measurement of information desires and anxiety about illness in a sample of diabetic patients. The results can be used to improve the pharmaceutical care of this patient group. Method: The sample consisted of patients with a diagnosis of either insulin (IDDM) or non-insulin dependent diabetes mellitus (NIDDM). Standardised interviews were conducted in out-patient diabetic clinics and on medical wards at a London teaching hospital. The questionnaire comprised three parts: socio-demographic variables, a quantitative set of 21 Likert-response items and 5 qualitative open questions. Responses were coded and analysed in the statistical software programs SPSS (quantitative) and QSR NUD*ISTv4 (qualitative). Results: 101 patients were recruited and interviewed, of which NIDDM patients comprised 62%. The questionnaire items were examined using factor analytic method, with the resultant structure matrix suggesting one factor within each scale. The EID scale (extent of information desired) consisted of six items (reliability coefficient alpha = 0.7), and the AI scale (anxiety towards illness) five items (reliability coefficient alpha = 0.8). Significant associations were found between EID scale scores and age, marital status, occupation and educational qualified level (p<0.05). Patients who score low on the EID scale tend to be widowed, economically inactive and manual workers and with low educational qualifications. The AI scale scores were associated with ethnicity and occupation and separate non-white and lower socio-economic groups as more anxious about their diabetes. Conclusion: This study has verified the use of the EID and AI scales as potentially valuable tools to measure desire for drug information and anxiety about the illness in diabetic patients. These two scales together can help health professionals to better target patients to provide appropriate medical information. This will increase patients’ satisfaction and better ensure their adherence to therapy. References: 1. Cichanowski P. S., Katon W. J., Russo J. E., and Walker E. A. The Patient-Provider Relationship: Attachment Theory and Adherence to Treatment in Diabetes. Am J Psychiatry 2001; 158 (1): 29-35. 2. Astrom K., Carlsson J., Bates I., Webb D. G., Duggan C., Sanghani P., and McRobbie D., Desire for information about drugs. A multi-method study in general medical inpatients, Pharmacy World & Science 2000; 22 (4):159-64. 3. Duggan C. and Bates I., Development and evaluation of a survey tool to explore patients’ perceptions of their prescribed drugs and their need for drug information, International Journal of Pharmacy Practice 2000; 8: 42-52.

medical information; drug information; diabetic patient; patients' desire; pharmaceutical care

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