> Diabetes, the empathy of the physician reduces the complications

The research has been published in the September issue of the “Academic& Medicine”. The present study is based on a small study that began in 2011, led by some of the same researchers, which revealed that the level of empathy of doctors in the United States is correlated with the capacity of their patients with diabetes to manage their disease, as measured by the patients “hemoglobin A1c and low-density lipoproteinà”.

The 2011 study involved 29 family doctors and 891 diabetic patients.

These studies are the first 2 that make us aware that the clinical results are tangible of the patients are in reality linked to the level of empathy of the doctor,” explained Daniel Z. Louis, MS, managing director of the Centre for Research in Medical Education at the Jefferson Medical College of Philadelphia, Pennsylvania. Louis has worked in both the studies.

“there is real evidence that these patients with diabetes mellitus have had less complications when their physicians were more empathetic. Louis told Medscape Medical News. “This is incredible”, he added.

In this study, researchers used health data from ASL of Parma, Region Emilia-Romagna. Have studied the effect of the’empathy medical adult patients with diabetes mellitus type 1 or type 2, patients who were followed continuously for 5 years between 2002 and 2009 by a doctor who was part of the National Health Service.

To measure the empathy of the physician, the researchers sent physicians a tool, scientifically approved, called Scale Jefferson of empathy, or the JSE. Developed in 2001 at the ” Center of the Jefferson Medical College Research in Medical Education and Health care, the JSE includes 20 items that measure the capacity of a health care provider to understand the point of view of the patient. Available in 42 languages, the JSE has been used in the United States and internationally.

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The researchers measured the outcomes of patients with diabetes that were admitted to hospital in 2009 of complications of acute metabolic as the state hyperosmolar the coma. You are focused on the metabolic complications perché “[they] can develop quite rapidly,” write the researchers, “and their prevention has più probability; to be influenced by the doctor of the base, while the other complications are often managed by specialists whose specific contributions are difficult to track”.

Eighty-one  of the 242 doctors who have successfully completed the JSE have had high scores, ranging 112-137, which indicate a high level of empathy. Eighty-four of the doctors have had scores moderated from 97 to 111, and 77 doctors have had a low-scoring, between 49-96).

The doctors scored high had 7224 patients with diabetes, those with scores of moderate 7303 patients with diabetes, those with low scores had 6434 patients with diabetes. Of the 123 patients admitted to hospital with serious metabolic complications in 2009, the percentage of complications per 1000 patients was significantly più low for patients of physicians with high scores (4.0) than for those of the band  moderate, and low (7.1 and 6.5, respectively).

These results provoke interest for further study

This study has been well done and move the field forward,” said Kathryn I. Pollak, PhD, associate professor cancer prevention, detection and control program at the Cancer Institute at Duke in Durham, North Carolina. He cited the large size of the sample and the high response rate of 80%, one of the doctors invited to the JSE.

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Dr. Pollak told Medscape Medical News that the authors, for various reasons, have not the control of some clinical factors that may influence the complications of the disease. “It might be that the authors were not able to consider other measures, as the data have not been collected,” he wrote in an e-mail, “but it is possible (although unlikely) that the patients that were sick have been seen by doctors who were less able to be empathetic. “

The study is unique among all the other studies done until today on’s empathy , given that measures such as empathy, influence the clinical outcomes of patients, said Richard C. Wender, MD, chairman, Department of Family Medicine and Communityà at Jefferson University Hospitals.

The dr. Wender, instead, told Medscape Medical News that the empathy of the doctor may not be così as influential as the study seems to prove. Even if you think that it is reasonable to connect l’empathy of the physician with the clinical findings of the patients, not è yet clear whether the “usò that the doctor does or does not do in a particular patient has a strong capacity to determine whether or not a metabolic complication of acute occur,” he said.

The dr. Wender has also recommended the study of empathy in other populations of patients who have a long-term relationship with a physician, such as patients undergoing dialysis or patients with cancer.

dr. Pollak has suggested to study the effect of the’ empathy of the doctor also  on the survival of cancer patients.

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Dr. Wender said that  would like to see the studies on the empathy of the  doctor change the willà of the patient to continue  preventive care, like screening for cancer.


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3 aprile 2013