Can J Clin Pharmacol Vol 14 (2) Summer 2007:e251-e259; July 27, 2007 e251 ©2007 Canadian Society for Clinical Pharmacology. All rights reserved. “I TAKE WHAT I THINK WORKS FOR ME”: A QUALITATIVE STUDY TO EXPLORE PATIENT PERCEPTION OF DIABETES TREATMENT BENEFITS AND RISKS Kalpana M Nair 1 , Mitchell AH Levine 1,2 , Lynne H Lohfeld 3 , Hertzel C Gerstein 2,3 1 Centre for Evaluation of Medicines, St. Joseph’s Healthcare Hamilton, Hamilton, Canada; 2 Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Canada; 3 Department of Medicine, McMaster University, Hamilton, Canada Corresponding Author: nairk@mcmaster.ca _____________________________________________________________________________________ ABSTRACT Background Diabetes is impacting more and more people each year. A key aspect of disease management is patient adherence to prescribed treatments. Treatment adherence is influenced by many factors, including the understanding of a treatment’s benefits and risks. Objective This study sought to describe the experience of benefit and risk assessment for people with type 2 diabetes when making treatment decisions. Methods This study utilized qualitative research methods. Individual interviews were conducted using a semi- structured interview guide. Both purposeful and theoretical sampling was used. A grounded theory approach was employed to facilitate data collection and analysis. Results The 18 study participants were on varying treatment regimens for diabetes (diet therapy, oral medications, and insulin). Many people felt that they had not received enough information about the benefits and risks of treatment at the point of decision-making and later sought this information on their own. Participants did not seem to consciously assess treatment benefits and risks when treatments were prescribed or suggested, but rather continued to make decisions after the clinical encounter by means of experimentation or experience with treatments. In general, benefits and risks were conceptualized very broadly, and some people were not able to verbally articulate their perceptions of treatment benefits and risks. Conclusion Patients’ assessment of treatment benefits and risks is an ongoing, often unconscious process that requires continuous interaction with the health care system. Access to information and an opportunity to discuss treatment options with health care providers are important to people with diabetes when making treatment decisions. Keywords: Qualitative research, patient perspective, diabetes, benefit & risk assessment _____________________________________________________________________________________ he prevalence of diabetes in Canada has increased from 3.4% in 1994/95 to 4.5% in 2000/01, representing almost 1.1 million people 18 years or older. 1 The health care costs associated with diabetes are staggering -- almost 5 billion dollars (CAD) in 1998 2 , with a large proportion of costs resulting from serious complications that could be prevented if diabetes T