Knowledge and Evaluation Research Unit, Division of Endocrinology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Diabetes Care. 2012 Jan;35(1):47-9. doi: 10.2337/dc11-1082. Epub 2011 Nov 18.
Patients with diabetes may experience high burden of treatment (BOT), including treatment-related effects and self-care demands. We examined whether patients with type 2 diabetes and their clinicians discuss BOT, the characteristics of their discussions, and their attempts to address BOT during visits.
Two coders independently reviewed videos of 46 primary care visits obtained during a practice-based trial and identified utterances concerning BOT, classifying them by topic and by whether BOT was addressed (i.e., whether statements emerged aimed at alleviating BOT).
Of the 46 visits, 43 (93.5%) contained BOT discussions. Both coders identified 83 discussions: 12 involving monitoring, 28 treatment administration, 19 access, and 24 treatment effects. BOT was unambiguously addressed only 30% of the time.
BOT discussions usually arise during visits but rarely beget problem-solving efforts. These discussions represent missed opportunities for reducing treatment-related disruptions in the lives of patients with diabetes, which may affect adherence and well-being.
糖尿病患者可能会经历较高的治疗负担（BOT），包括与治疗相关的影响和自我护理需求。我们研究了 2 型糖尿病患者及其临床医生是否讨论过 BOT、他们讨论的特点，以及他们在就诊期间是否试图解决 BOT。
两名编码员独立审查了一项基于实践的试验中获得的 46 次初级保健就诊的视频，并确定了与 BOT 相关的话语，根据主题和 BOT 是否得到解决（即是否出现了旨在减轻 BOT 的陈述）对其进行分类。
在 46 次就诊中，有 43 次（93.5%）包含 BOT 讨论。两名编码员共确定了 83 次讨论：12 次涉及监测，28 次涉及治疗管理，19 次涉及治疗途径，24 次涉及治疗效果。BOT 仅在 30%的时间得到明确解决。
BOT 讨论通常在就诊期间出现，但很少产生解决问题的努力。这些讨论代表了减少糖尿病患者生活中与治疗相关的干扰的错失机会，这可能会影响他们的依从性和幸福感。
