Compliance or adherence problems are common in diabetes management. Many factors are potentially related to these problems, including demographic, psychological, social, health care provider and medical system, and disease- and treatment-related factors. The terms "compliance" and "adherence" are problematic constructs that may actually serve to perpetuate diabetes management difficulties. Because diabetes is a chronic illness requiring a variety of self-management behaviors, a patient-centered collaborative model of care recognizing patient autonomy provides a more skillful approach to improving diabetes self-care behaviors. To improve patients' diabetes self-management behaviors, health care providers should cultivate patient-centered relationships that respect patient autonomy; organize their clinic or office to be patient-friendly; provide continuity of care with interim telephone contacts; talk collaboratively with patients about treatment rationales and goals; brain-storm and problem-solve with their patients; gradually implement and tailor the regimen; provide written instructions; use self-monitoring, social supports and reinforcement, and behavioral contracts; and routinely refer patients to behavioral health specialists.
ASJC Scopus subject areas
- Internal Medicine
- Endocrinology, Diabetes and Metabolism