A Novel Application of the Problem Areas in Diabetes (PAID) Instrument to Improve Glycemic Control and Patient Satisfaction

Abstract

Purpose The purpose of this study was to use the Problem Areas in Diabetes (PAID) instrument in a novel manner and assess whether providing primary care physicians the results of the questionnaire completed by their patients immediately prior to a clinical encounter would result in improvement in a patient’s glycemic control and/or postencounter satisfaction score. Methods A 6-month longitudinal pilot study, involving 4 general internal medicine physicians and 61 patients in 4 separate offices, was designed. The patient sample was 54% male and 46% female with ages from 41 to 91. The sample included newly diagnosed diabetic patients and those with longstanding disease; as such, the patient population had a range of diabetes-related complications from none to end-stage renal disease. At baseline, 3-month, and 6-month clinic visits, patients completed the PAID questionnaire, and results were provided to the physician prior to the clinical encounter. Satisfaction was measured postencounter. A1C was checked at all 3 visits with the first visit serving as baseline. Results Patients in all 3 groups had improved hemoglobin A1C, reduced perceived problem areas, and increased satisfaction with the quality of care received. These effects were most pronounced after the first visit and for patients with poorer quality of glycemic control at baseline. Conclusions The PAID instrument facilitates a therapeutic dialogue between patient and physician, has the most effect at the initial encounter, and makes the most impact on at-risk patients presenting with poor glycemic control.