Patient-Centered Care, Glycemic Control, Diabetes Self-Care, and Quality of Life in Adults with Type 2 Diabetes. Diabetes Technol Ther 2016 Oct;18(10):644-649
Date
10/18/2016Pubmed ID
27541872Pubmed Central ID
PMC5069713DOI
10.1089/dia.2016.0079Scopus ID
2-s2.0-84992109241 (requires institutional sign-in at Scopus site) 40 CitationsAbstract
BACKGROUND: The Affordable Care Act places a newfound emphasis on patient-centered medical home and patient-centered care (PCC). The purpose of this study was to evaluate the relationship between PCC, diabetes self-care, glycemic control, and quality of life (QOL) in a sample of adults with type 2 diabetes.
METHODS: Six hundred fifteen patients were recruited from two adult primary care clinics in the southeastern United States. Primary outcome variables were self-care behaviors (medication adherence, diet, exercise, blood sugar testing, and foot care), glycemic control, and QOL (physical component summary [PCS] score and mental component summary [MCS] score of SF12). PCC was assessed using a modified 7-item Picker Patient Experience Questionnaire. Regression modeling was used to assess independent associations while adjusting for relevant covariates.
RESULTS: In adjusted analyses, PCC was significantly associated with PCS QOL (β = -0.03, 95% confidence interval [CI] -0.05 to -0.01), MCS QOL (β = 0.09, 95% CI 0.04-0.14), medication adherence (β = 0.12, 95% CI 0.08-0.17), general diet (β = 0.12, 95% CI 0.07-0.17), specific diet (β = 0.05, 95% CI 0.01-0.08), blood sugar testing (β = 0.09, 95% CI 0.04-0.15), and foot care (β = 0.12, 95% CI 0.07-0.18).
CONCLUSION: PCC is associated with diabetes self-management and QOL, but was not significantly associated with glycemic control in patients with diabetes. PCC may be an important factor in self-care behaviors, but the process of focusing care around the patient may need to expand throughout the healthcare system before changes in outcomes such as glycemic control are noted.
Author List
Williams JS, Walker RJ, Smalls BL, Hill R, Egede LEAuthors
Leonard E. Egede MD Center Director, Chief, Professor in the Medicine department at Medical College of WisconsinRebekah Walker PhD Associate Professor in the Medicine department at Medical College of Wisconsin
Joni Williams MD, MPH Associate Professor in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AgedBlood Glucose
Blood Glucose Self-Monitoring
Diabetes Mellitus, Type 2
Diet
Exercise
Female
Health Knowledge, Attitudes, Practice
Humans
Male
Medication Adherence
Middle Aged
Patient Protection and Affordable Care Act
Patient-Centered Care
Quality of Life
Self Care
