Minimally Disruptive Medicine

Jill Adams has written a very nice piece about the challenge before patients with type 2 diabetes seeking to decide how much they need to do to manage their disease and prevent complications.   The piece goes further and cites our group in seeking “good enough” diabetes control and mentions the work of being a patient.  Ms. Adams writes:

Montori notes that a good-enough blood sugar strategy would also ease the sheer time and energy it takes to manage diabetes. Treatment regimens — with frequent doses of pills or insulin, blood-sugar monitoring and doctor visits — are complicated and burdensome, particularly in patients who may be elderly and have other chronic conditions, such as high blood pressure and high cholesterol. One estimate of the time patients spend taking care of their condition, if they follow all the advice of their doctors, is 143 minutes per day. “That’s as much as a part-time job,” Montori says.

The link to the full article (LA Times, Oct 26 2009) is here

We just received great news!

The MDM team, led by Frances Mair just got awarded a grant from Chief Scientist Office of Scotland to conduct the project “Developing a conceptual model of the burden of treatment and the “work” involved in living with heart failure”. Other investigators mentioned in the award include Carl May and Victor Montori.

Here is the project summary:

This project grant is the first in a program of research developing the “Minimally Disruptive Medicine (MDM)” research agenda.  Poor adherence to treatment regimens and lifestyle advice may lead to an additional burden of poor health for chronic heart failure (CHF) patients, their families and the health service.  Non-adherence is often regarded as a problem of individual volition or about lack of patient understanding. However, CHF patients often have multiple co-morbidities – and generally face an increasing burden of work in managing their conditions. This work includes complex pharmaceutical regimes, frequent clinic attendances, lifestyle changes and self care responsibilities.

As this treatment burden grows, patients find it difficult to meet the demands placed on them. In this project we aim to identify, describe, and explain the work involved in living with CHF, through analysis of both archived and new CHF patient perception interviews.  We aim to develop a robust conceptual model of CHF work in order to inform the development of new points (and forms) of clinical intervention.

Here we go!