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Monday, March 21, 2011

Diabetes Management: Caring Doctors Improve Patients' A1c, LDL Scores

A doctor's empathy can improve the care of diabetes patients, a three-year study between 2006 and 2009 involving 891 diabetes patients treated by 29 doctors at the Thomas Jefferson University Hospital in Philadelphia has confirmed. This will reinforce the popular belief that acaring doctor plays a big role in a patient’s disease management.

The findings – published in the March issue of the journal Academic Medicine ‒ indicate that empathy on the part of doctors can contribute to patient satisfaction, trust and compliance with therapy.

For the study, results of the most recent HbA1c and LDL-C tests were extracted from the patients' electronic records. The results of HbA1c tests were categorized into good control (<7.0%) and poor control (>9.0%). Similarly, the results of the LDL-C (“bad” cholesterol) tests were grouped into good control (<100) and poor control (>130).

The physicians, who completed the Jefferson Scale of Empathy (JSE) in 2009, were grouped into high, moderate, and low empathy scorers. (The JSE was developed by researchers at the Center for Research in Medical Education and Health Care at Jefferson Medical College to measure empathy in physicians and health professionals, medical students, and health professions students. The scale is a self-administered 20-item test comprising a 7-point Likert scale that can be completed in 5-10 minutes. The JSE scales are used extensively in the United States and abroad.)

When associations between physicians' level of empathy scores and patient outcomes were examined, it was found that patients of physicians with high empathy scores were significantly more likely to have good control of HbA1c (56%) than were patients of physicians with low empathy scores (40%, P < .001).

Similarly, the proportion of patients with good LDL-C control was significantly higher for physicians with high empathy scores (59%) than physicians with low scores (44%, P < .001). Logistic regression analyses indicated that physicians' empathy had a unique contribution to the prediction of optimal clinical outcomes after controlling for physicians' and patients' gender and age, and patients' health insurance.

In other words, while the researchers assessed the doctors' level of empathy for patients, the quality of patient care was determined by an LDL ("bad") cholesterol test and an HbA1C test for blood glucose levels. Patients whose doctors had high empathy scores were more likely to have good control of their blood sugar and low LDL cholesterol levels than patients whose doctors had low empathy scores.

"Our results show that physicians with high empathy scores had better clinical outcomes than other physicians with lower scores," study author Mohammadreza Hojat, research professor of psychiatry and human behavior at Jefferson Medical College, said in a university news release.

"These findings, if confirmed by larger scale research, suggest that empathy should be viewed as an integral component of a physician's competence," he concluded.

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