Patients’ perceptions of the extent to which their health care needs have been met may affect compliance with prescribed health
behaviors and related health outcomes. The authors examined the relationships of “patient request fulfillment” to patient
compliance, glycemic control, and several other health care outcomes in 51 adult outpatients with insulin-dependent diabetes
mellitus. On average, patients retrospectively cited 4.5 long-term requests, of which over three-fourths were fulfilled. Fulfillment
of these requests was significantly associated with patient satisfaction, perceived health status, fewer insulin reactions,
and greater insulin injection time reliability (p<0.05), but not with several other measures of compliance. Higher patient
request fulfillment at single visits was correlated, as hypothesized, with subsequent reduction in glycosylated hemoglobin,
but this association was not statistically significant. These results suggest that patient request fulfillment is associated
with several aspects of health behavior and health status in adults with insulin-dependent diabetes. Further studies are needed
to confirm these observations and determine whether strategies to enhance patient request fulfillment can enhance health care
outcomes.
Key words patient participation - compliance - patien satisfaction - physicianpatient relations - patient outcome assessment - diabetes mellitus, insulin-dependent
Supported in part by the Northwest Health Services Research and Development Field Program, Seattle Veterans Administration
Medical Center. Dr. Uhlmann was a Veterans Administration Fellow in the Robert Wood Johnson Clinical Scholars Program while
working on this project and is the recipient of National Institute on Aging Academic Award K08 AG00265. The opinions expressed
herein are those of the authors and not necessarily those of the Veterans Administration or the Robert Wood Johnson Foundation.