Diabetes: Understanding the patient perspective

November 14, 2017
Understanding the patient perspective directly influences care strategy and the need for continuity of care.

Excerpted from page 26 of the November/December 2016 edition of AOA Focus.

Strong communication is a linchpin to improved diabetes care coordination, be it among physicians, other professions and patients themselves.

The inaugural "Transforming Diabetes Care Workshop," a venture from AOA, Johnson & Johnson Vision and Johnson & Johnson Diabetes Institute offered just prior to Optometry's Meeting® 2016 in Boston, Massachusetts, took doctors of optometry one step further in realizing how to further connect with patients. It put doctors in patients' shoes.

The all-day workshop—designed to elicit an empathetic understanding of a patient's daily life—had participants track their blood-glucose levels with glucometers, use an insulin pump and count carbs daylong, all the while attending diabetes education.

Millicent Knight, O.D., vice president of professional affairs, North America, Johnson & Johnson Vision, says an impetus for this workshop came from the vast reports of optometric visits for diabetes-related eye problems mostly as a result of noncompliance with blood sugars.

"We often refer to these patients as diabetics, but they are more than their condition, these are patients with diabetes; it's about changing the way we look at our patients," Dr. Knight says.

And with that, imparting a patient perspective on managing a daily schedule, counting carbs, taking insulin and managing comorbidities.

"As I went through the program, I found it stressful just trying to keep up with all the things you must think about day in and day out—it's almost a full-time job."

Given these considerations, Dr. Knight hopes that doctors come away with a more complete perspective of patient challenges in managing blood sugar levels. That way, as doctors encounter patients with suboptimal levels, the conversation starts with a more understanding and less judgmental tone.

"We need to take the approach of 'how can I help you manage these challenges easier?'" Dr. Knight says. "It's a group effort, and it's necessary to have the proper support to help manage this condition."

Coming full circle, understanding the patient perspective directly influences care strategy and the need for continuity of care. Could optometry—already a waypoint on the diabetes management plan—better help patients access the health care system, ensuring they're receiving necessary eye and systemic care?

Dr. Knight thinks so.

That could involve developing a standardized model that moves a patient with diabetes through the optometric practice, into the system and back to the o­ffice for routine care.

On a more individual note, it also means additional continuing education on the doctor's side of the equation to stay updated on standards of care.

"It's not just about managing patients with diabetes-related eye conditions and making sure they come back to monitor progression, but looking long term at your role in their overall care in the health care arena," she says.

Stay current with your diabetes clinical knowledge by accessing continuing education courses at EyeLearn: Professional Development Hub , the AOA's member-exclusive centralized education platform.

Access the evidence-based clinical practice guideline Eye Care of the Patient with Diabetes Mellitus—Second Edition.

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