Grant: Travel Awards - Institute Community Support

Living with diabetes requires many daily activities and tasks that can be time-consuming, complex, and overwhelming. This affects the daily lives of people living with diabetes. To address this burden, it needs to be discussed in clinical encounters. So, we studied how it is discussed in clinical encounters with family physicians, if any solutions were proposed to decrease such burden, how it is documented in clinical notes and if it is linked to the burden perceived by the patient. We conducted a study in a rural clinic in Quebec, Canada. We videorecorded 32 clinical encounters between patients living with diabetes and their family physicians. Then we analyzed how the burden is discussed in these encounters. We also analyzed the clinical notes of these encounters to see how these discussions were documented. Finally, we asked patients to fill out a questionnaire about their burden of treatment to measure their perception of the burden. We found that the discussion of the burden of treatment is present in clinical encounters between patients living with diabetes and their family physicians. Patients start most of such discussions, and most often they invoke an action from family physicians (e.g., direct action to decrease the burden, treatment changes, discussion of burden self-management resources for the patient). In terms of documentation, treatment changes were the most documented. Although we did not find a link between the number of discussions and the burden perceived by the patient, our findings suggest that patients with women physicians had more discussions in their clinical encounters.