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Patient-reported use of collaborative goal setting and glycemic control among patients with diabetes

Archived Abstract of Former PSC Researcher

Lafata, Jennifer Elston, Heather L. Morris, Elizabeth Dobie, Michele Heisler, Rachel M. Werner, and Levent Dumenci. 2013. "Patient-reported use of collaborative goal setting and glycemic control among patients with diabetes." Patient Education and Counseling, 92(1): 94-99.

Objective: Little is known about how patient-clinician communication leads to better outcomes. Among patients with diabetes, we describe patient-reported use of collaborative goal setting and evaluate whether perceived competency and physician trust mediate the association between collaborative goal setting and glycemic control. Methods: Data from a patient survey administered in 2008 to a cohort of insured patients aged 18+ years with diabetes who initiated oral mono-therapy between 2000 and 2005 were joined with pharmaceutical claims data for the prior 12 months and laboratory data for the prior and subsequent 12 months (. N=. 1065). A structural equation model (SEM) was used to test mediation models controlling for baseline HbA1c. Results: The hypothesized mediation model was supported. Patient-reported use of more collaborative goal setting was associated with greater perceived self-management competency and increased level of trust in the physician (. p<. 0.05). In turn, both greater perceived competence and increased trust were associated with increased control (. p<. 0.05). Conclusions: Findings indicate that engaging patients in collaborative goal setting during clinical encounters has potential to foster a trusting patient-clinician relationship as well as enhance patient perceived competence, thereby improving clinical control. Practice implications: Fostering collaborative goal setting may yield payoffs in improved clinical outcomes among patients with diabetes.

DOI:10.1016/j.pec.2013.01.016 (Full Text)

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