Patient-Centered Care, Diabetes Empowerment, and Type 2 Diabetes Medication Adherence Among American Indian Patients

Ratner, Nathan; Davis, Emily B.; Lhotka, Laura L.; Wille, Stephanie; Walls, Melissa L.

doi:10.2337/cd17-0008

Cited by 14 publications

(7 citation statements)

References 18 publications

(28 reference statements)

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“…The five communities have provided tribal resolutions in support of the project, and letters of support have been provided by the Indian Health Service (IHS) clinics partnering in this research. Maawaji idi-oog mino-ayaawin is a mixed-methods study consisting of a qualitative phase followed by a quantitative phase, with further details provided elsewhere (Ratner, Davis, Lhotka, Wille, & Walls, 2017; Walls, et al, 2017; Elm, Walls, & Aronson, 2019). The study protocol and procedures were reviewed and approved by the University of Minnesota and Indian Health Service National Institutional Review Boards.…”

Section: Methodsmentioning

confidence: 99%

The Mediating Role of Diabetes Distress and Depressive Symptoms in Type 2 Diabetes Medication Adherence Gender Differences

2019

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Background. Medication adherence is negatively related to both diabetes distress (DD) and depressive symptoms (DS). Past research suggests gender differences in adherence, DD, and DS. A gap exists in determining if gender differences in adherence are mediated by DD and DS, or if gender moderates differences in adherence by DD/DS. Aims. This study investigated the relationship between gender, DD, DS, and medication adherence and tested for mediating and moderating effects on medication adherence among American Indian adults with type 2 diabetes. Method. The Maawaji idi-oog mino-ayaawin (Gathering for Health) study was a community-based participatory research collaboration with five American Indian tribes. Participants, randomly recruited from clinic records, shared information during computer-assisted personal interviews. This study includes the 166 participants who reported using medications to treat their diabetes. The relationship between gender, DD, DS, and medication adherence are explored. Possible mediating and moderating effects on medication were tested using regression and path analysis. Results. Females had higher levels of DD and DS and lower levels of medication adherence. Higher levels of DD and DS were both associated with lower medication adherence. No evidence was found that gender moderates the relationship between DD or DS and medication adherence. Instead, DD and DS mediated the relationship between gender and medication adherence. Conclusions. Medication adherence differences in male and female patients may be attributable to DD and DS. The present research highlights both DD and DS as targets for clinicians and researchers alike.

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Section: Methodsmentioning

confidence: 99%

The Mediating Role of Diabetes Distress and Depressive Symptoms in Type 2 Diabetes Medication Adherence Gender Differences

2019

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“…This means that the bulk of management and care for this lifelong disease falls upon patients and their caregivers [ 7 ]. Hence, empowering patients with the necessary knowledge and skills to better manage their chronic conditions is key in diabetes care [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Illness perceptions, self-care practices, and glycemic control among type 2 diabetes patients in Chiang Mai, Thailand

et al. 2022

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Background Diabetes Self-Management Education (DSME) is a fundamental aspect of diabetes care, but no standard program exists in Thailand. Understanding current patterns of illness perceptions (concerns) and self-management practices among patients with diabetes in Thailand is vital to develop culturally tailored DSME programs. This study sought to explore the association between reported self-management practices and diabetes perceptions on glycemic control among patients with type 2 diabetes in Chiang Mai Province, Thailand. Specifically, the study examined whether the association between illness perceptions and diabetes control was mediated by self-management. Methods This was a cross-sectional study conducted among type 2 diabetes patients on outpatient care and follow-up in four districts hospitals in Chiang Mai, Thailand. Illness perceptions was measured by the Brief Illness Perceptions Questionnaire (BIPQ). Self-management practices were measured by Summary Diabetes Self-Care activities (SDSCA). For illness perceptions and self-management practices, patients were classified into two groups, high level and low level based on the median values. Univariate and multivariable analyses were done to determine the association between the determinant factors: self-care practices and illness perceptions and the outcome of interest- good glycemic control (HbA1c < 7%). Results Of the 200 participants recruited into the study, 180 completed the questionnaire. Only 35% of participants had good glycemic control (HBA1c < 7.0). Both illness perceptions and self-management practices were independently linked to glycemic control. Among illness perceptions, a sense of personal control was strongly associated with good glycemic control (p = 0.01). For self-management, appropriate diet (p = 0.03) and medication adherence (p = 0.05) were associated with good glycemic control. After adjustments for key baseline characteristics, patients with high levels of illness perceptions were less likely to achieve glycemic control (OR 0.55, 95% CI 0.29 to 1.14, p = 0.11) and those with high level of self-management were more likely to achieve glycemic control (OR 2.11, 95% CI 1.04 to 4.30, p = 0.04). The effect size for illness perception attenuated when further adjusted for levels of self-management (OR 0.88, 95% CI 0.39 to 1.96, p = 0.75) while the effect size for self-management and glycemic control did not materially change (OR 2.30, 95% CI 1.06 to 5.02, p = 0.04). Conclusion Illness perceptions and self-management practices are associated with glycemic control. Future culturally tailored interventions in Thailand aimed at improving glycemic should focus on personal control, improving diet and treatment adherence as these are more likely to help improve diabetes control as demonstrated in this study.

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“…Each community had a community research council to guide the research and serve as active partners in research from start to finish. The methods for this study are described elsewhere (see: Elm et al, 2019;Ratner et al, 2017;Walls et al, 2017).…”

Section: Methodsmentioning

confidence: 99%

A longitudinal study of the stress of poor glucose control and diabetes distress

et al. 2019

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Poor glucose control can be viewed as a stressor, possibly promulgating diabetes distress. We examined the relationship between perceived blood glucose control and diabetes distress over time using a partially controlled cross-lagged path analysis model. After controlling for demographics, control at 6 months was directly related to change in distress at 12 months. Subsequently, distress at 12 months was directly related to change in control at 18 months. Both 6-month control and distress had significant indirect effects on 18-month control and distress. This demonstrates the nuanced bi-directional relationship between the stress of poor perceived control and diabetes distress.

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Patient-Centered Care, Diabetes Empowerment, and Type 2 Diabetes Medication Adherence Among American Indian Patients

Cited by 14 publications

References 18 publications

The Mediating Role of Diabetes Distress and Depressive Symptoms in Type 2 Diabetes Medication Adherence Gender Differences

The Mediating Role of Diabetes Distress and Depressive Symptoms in Type 2 Diabetes Medication Adherence Gender Differences

Illness perceptions, self-care practices, and glycemic control among type 2 diabetes patients in Chiang Mai, Thailand

A longitudinal study of the stress of poor glucose control and diabetes distress

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