MANAGEMENT OF TYPE-2 DIABETES-MELLITUS IN FRANCE - ATTITUDES AND PRACTICES AMONG A REPRESENTATIVE SAMPLE OF GENERAL-PRACTITIONERS

Purpose : Medical knowledge regarding chronic illness has increased in recent years. Critical gaps in our understanding of the educational f actors necessary to change the clinical aspects of most diseases remai n. The role of the general practitioner, the primary care provider, in the delivery of educational interventions has not been clearly define d. Methods : For the first phase in the educational diagnosis of Type 2 diabetic patients treated by general practitioners in France, a stra tified random sample of 8 % of general practitioners was drawn; 70 % a greed to be interviewed. Results : Demographic characteristics of phys icians were comparable with previous studies. Physicians accepted the seriousness of the disease. 75,9 % devoted at least as much time to th e psychological as to the somatic aspects of the disease. 74,7 % repor ted using a co-active approach with patients, permitting the use of mo re innovative educational strategies. Logistic regression analysis ind icated that the ages of the physicians and patients, inclusion of the family, the number of patients seen, and the perception of patients as compliant were predictive of the co-active approach. Conclusions : Th e overwhelming proportion of physicians who use the co-active approach was the single most important factor in the development of an educati onal intervention where the general practitioner serves as the primary , continuous reinforcer for long-term behavior change. This program is currently being tested in a randomized clinical trial among general p ractitioners in France.