The Effect of Patient-Provider Relationships on Compliance in Uncontrolled Diabetic Patients.

Background Effective patient-provider communication is critical for managing chronic diseases like diabetes mellitus (DM). This study examines whether patient attitudes toward their healthcare providers influence diabetes management and compliance, comparing individuals with poorly managed diabetes mellitus (PM DM) and those without DM (No DM).  Methods Data from the All of Us Research Program was analyzed. After excluding incomplete responses, the final sample included 1903 PM DM patients and 94,218 No DM patients. Patient perceptions of respect, involvement in medical decision making, and provider interactions were assessed. Bivariate analysis was used to identify responses that were independently associated with PM DM. Variables found to be independently associated with PM DM at p<0.10 were entered into a multivariable model, and backwards stepwise binary logistic regression was used to find the model of best fit. Variables found to be significant (p<0.05) in the multivariable model were retained.  Results Patients who felt disrespected by providers were significantly more likely to have poorly managed diabetes (OR = 1.396, 95% CI: 1.189, 1.639, p<0.05). Counterintuitively, patients who reported always being asked for their opinion in treatment decisions were likely to have PM DM (OR = 1.466, 95% CI: 1.235, 1.740, p<0.05). Patients who were not nervous to see their provider were also more likely to have PM DM (OR = 1.365, 95% CI: 1.152, 1.618, p<0.05). Conclusion Findings suggest that positive provider interaction does not always translate to better disease control. Future studies should explore how communication styles and shared decision-making impact long-term adherence to diabetes treatment.