Psychosocial problems and barriers to improved diabetes management: results of the Cross‐National Diabetes Attitudes, Wishes and Needs (DAWN) Study

TLDR

The study aims to assess psychosocial problems and barriers to effective self‑care reported by patients and providers, and to evaluate available resources for addressing these issues. A cross‑sectional survey of 5,104 adults with type 1 or type 2 diabetes and 3,827 health‑care providers across 13 countries collected face‑to‑face or telephone interview data. The study found that patients had poor diet and exercise adherence, widespread diabetes‑related worries, 41 % with poor psychological well‑being, and although providers recognized these issues, most lacked resources and only 10 % of patients received psychological treatment, indicating that psychosocial problems are common worldwide and addressing them could improve outcomes.

Abstract

Abstract Aims To examine patient‐ and provider‐reported psychosocial problems and barriers to effective self‐care and resources for dealing with those barriers. Methods Cross‐sectional study using face‐to‐face or telephone interviews with diabetic patients and health‐care providers in 13 countries in Asia, Australia, Europe and North America. Participants were randomly selected adults ( n = 5104) with Type 1 or Type 2 diabetes, and providers ( n = 3827), including primary care physicians, diabetes specialist physicians and nurses. Results Regimen adherence was poor, especially for diet and exercise; provider estimates of patient self‐care were lower than patient reports for all behaviours. Diabetes‐related worries were common among patients, and providers generally recognized these worries. Many patients (41%) had poor psychological well‐being. Providers reported that most patients had psychological problems that affected diabetes self‐care, yet providers often reported they did not have the resources to manage these problems, and few patients (10%) reported receiving psychological treatment. Conclusions Psychosocial problems appear to be common among diabetic patients worldwide. Addressing these problems may improve diabetes outcomes, but providers often lack critical resources for doing so, particularly skill, time and adequate referral sources.