PMID- 30685382
OWN - NLM
STAT- MEDLINE
DCOM- 20200415
LR  - 20200415
IS  - 1878-0210 (Electronic)
IS  - 1878-0210 (Linking)
VI  - 13
IP  - 4
DP  - 2019 Aug
TI  - Which patients with type 2 diabetes mellitus are perceived as 'difficult' by 
      general practitioners?
PG  - 353-359
LID - S1751-9918(18)30250-X [pii]
LID - 10.1016/j.pcd.2019.01.001 [doi]
AB  - AIMS: To find factors that are associated with a general practitioner's (GP's) 
      subjective impression of a patient being 'difficult' within a sample of patients 
      with type 2 diabetes mellitus (T2DM). METHODS: Secondary cross-sectional analysis 
      of a cohort of GP patients with T2DM. GP questionnaire on clinical data and GPs' 
      subjective ratings of patient attributes (including 'patient difficulty'). 
      Patient questionnaire on sociodemographics and illness perceptions. Bivariate and 
      multivariate analyses, adjusted for cluster-effect of GP practice. RESULTS: Data 
      from 314 patients from 49 GPs could be analysed. Independent associations with 
      higher GP-rated difficulty were found for (odds ratio; 95% confidence interval): 
      male patients from male GPs (1.27; 1.06-1.53), unmarried men (1.25; 1.04-1.51), 
      men with non-German nationality (1.80; 1.24-2.61), patients perceiving more 
      problems with diabetes (1.17; 1.04-1.30), patients with higher BMI (1.01; 
      1.00-1.02) and HbA1c values (1.06; 1.02-1.10), patients being perceived by the GP 
      as less adherent (1.34; 1.22-1.46) and less health-literate (1.19; 1.04-1.35). 
      CONCLUSIONS: The impact of patients' gender and illness perception yield new 
      insights into GP-perceived complexity of care. Culturally and gender-sensitive 
      communication techniques for adapting health care goals to patients' problems 
      (rather than norm values) may alleviate GPs' work.
CI  - Copyright (c) 2019 Primary Care Diabetes Europe. Published by Elsevier Ltd. All 
      rights reserved.
FAU - Pentzek, Michael
AU  - Pentzek M
AD  - Institute of General Practice (ifam), Medical Faculty, Heinrich-Heine University 
      Dusseldorf, Werdener Str. 4, 40227 Dusseldorf, Germany. Electronic address: 
      pentzek@med.uni-duesseldorf.de.
FAU - Santos, Sara
AU  - Santos S
AD  - Institute of General Practice (ifam), Medical Faculty, Heinrich-Heine University 
      Dusseldorf, Werdener Str. 4, 40227 Dusseldorf, Germany. Electronic address: 
      sara.santos@med.uni-duesseldorf.de.
FAU - Wollny, Anja
AU  - Wollny A
AD  - Institute of General Practice, University Medical Center Rostock, Doberaner 
      Strasse 142, 18057 Rostock, Germany. Electronic address: 
      anja.wollny@med.uni-rostock.de.
FAU - Gummersbach, Elisabeth
AU  - Gummersbach E
AD  - Institute of General Practice (ifam), Medical Faculty, Heinrich-Heine University 
      Dusseldorf, Werdener Str. 4, 40227 Dusseldorf, Germany. Electronic address: 
      elisabeth.gummersbach@med.uni-duesseldorf.de.
FAU - Herber, Oliver Rudolf
AU  - Herber OR
AD  - Institute of General Practice (ifam), Medical Faculty, Heinrich-Heine University 
      Dusseldorf, Werdener Str. 4, 40227 Dusseldorf, Germany. Electronic address: 
      oliver.herber@med.uni-duesseldorf.de.
FAU - In der Schmitten, Jurgen
AU  - In der Schmitten J
AD  - Institute of General Practice (ifam), Medical Faculty, Heinrich-Heine University 
      Dusseldorf, Werdener Str. 4, 40227 Dusseldorf, Germany. Electronic address: 
      jids@med.uni-duesseldorf.de.
FAU - Icks, Andrea
AU  - Icks A
AD  - Institute for Health Services Research and Health Economics, Medical Faculty, 
      Heinrich-Heine University Dusseldorf, Moorenstr. 5, 40225 Dusseldorf, Germany. 
      Electronic address: andrea.icks@uni-duesseldorf.de.
FAU - Abholz, Heinz-Harald
AU  - Abholz HH
AD  - Institute of General Practice (ifam), Medical Faculty, Heinrich-Heine University 
      Dusseldorf, Werdener Str. 4, 40227 Dusseldorf, Germany. Electronic address: 
      abholz@med.uni-duesseldorf.de.
FAU - Wilm, Stefan
AU  - Wilm S
AD  - Institute of General Practice (ifam), Medical Faculty, Heinrich-Heine University 
      Dusseldorf, Werdener Str. 4, 40227 Dusseldorf, Germany. Electronic address: 
      stefan.wilm@med.uni-duesseldorf.de.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20190123
PL  - England
TA  - Prim Care Diabetes
JT  - Primary care diabetes
JID - 101463825
SB  - IM
MH  - Aged
MH  - *Attitude of Health Personnel
MH  - Cross-Sectional Studies
MH  - Cultural Characteristics
MH  - Diabetes Mellitus, Type 2/diagnosis/ethnology/psychology/*therapy
MH  - Female
MH  - General Practitioners/*psychology
MH  - Germany/epidemiology
MH  - *Health Behavior/ethnology
MH  - *Health Knowledge, Attitudes, Practice/ethnology
MH  - Health Literacy
MH  - Humans
MH  - Illness Behavior
MH  - Male
MH  - Middle Aged
MH  - Patient Compliance
MH  - Patients/*psychology
MH  - *Physician-Patient Relations
MH  - Sex Factors
MH  - Single Person/psychology
OTO - NOTNLM
OT  - Complexity
OT  - Doctor-patient communication
OT  - Primary care
OT  - Type 2 diabetes mellitus
EDAT- 2019/01/28 06:00
MHDA- 2020/04/16 06:00
CRDT- 2019/01/28 06:00
PHST- 2018/08/02 00:00 [received]
PHST- 2018/12/02 00:00 [revised]
PHST- 2019/01/02 00:00 [accepted]
PHST- 2019/01/28 06:00 [pubmed]
PHST- 2020/04/16 06:00 [medline]
PHST- 2019/01/28 06:00 [entrez]
AID - S1751-9918(18)30250-X [pii]
AID - 10.1016/j.pcd.2019.01.001 [doi]
PST - ppublish
SO  - Prim Care Diabetes. 2019 Aug;13(4):353-359. doi: 10.1016/j.pcd.2019.01.001. Epub 
      2019 Jan 23.