Patient-centered care, glycemic control, diabetes self-care, and quality of life in adults with type 2 diabetes

JS Williams, RJ Walker, BL Smalls, R Hill… - Diabetes technology & …, 2016 - liebertpub.com
Diabetes technology & therapeutics, 2016liebertpub.com
Abstract 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 …
Abstract
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.
Mary Ann Liebert
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