Continuity of care, self-management behaviors, and glucose control in patients with type 2 diabetes

Title

Continuity of care, self-management behaviors, and glucose control in patients with type 2 diabetes

Creator

Parchman M; Pugh J; Noel PH; Larme A

Publisher

Medical Care

Date

2002

Subject

Female; Humans; Male; Adult; Prospective Studies; Middle Aged; Outcome Assessment (Health Care); Primary Health Care; Diabetes Mellitus; Continuity of Patient Care; Health Behavior; Self Care; Type 2/psychology; Type 2/therapy

Description

BACKGROUND: The influence of continuity of care on outcomes of care for patients with type 2 diabetes is poorly understood. OBJECTIVE: To examine the relationships between continuity, glucose control, and advancement through stages of change for self-management behaviors. DESIGN: Prospective cohort study. SETTING: Five community health centers on the Texas-Mexico border. SUBJECTS: A random sample of 256 adults, 18 years of age and older with an established diagnosis of type 2 diabetes. MEASURES: Stage of change for diet and exercise were assessed during two patient interviews, averaging 18.9 months apart. Phlebotomy was performed at each interview to measure glycosolated hemoglobin (HbA1C). Medical records were abstracted for ambulatory care utilization. A continuity score was calculated based on the number of visits and number of providers seen. RESULTS: Patients who advanced one or more stages of change for diet had higher levels of continuity. As continuity improved, the change in HbA1C was smaller. (r = -0.25; P <0.001) This relationship remained significant after controlling for number of visits, months since diagnosis, number of days in the study, duration of diabetes, and advancement in stage of change for diet. Advancement through stage of change for diet explained a significant amount of the variance in the relationship between continuity and HbA1C (t test = -11.33; P <0.01). CONCLUSIONS: Continuity of care with a primary care provider is associated with better glucose control among patients with type 2 diabetes. This relationship appears to be mediated by changes in patient behavior regarding diet.
2002

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Type

Journal Article

Citation List Month

Backlog

Pages

137-144

Issue

2

Volume

40

Citation

Parchman M; Pugh J; Noel PH; Larme A, “Continuity of care, self-management behaviors, and glucose control in patients with type 2 diabetes,” Pediatric Palliative Care Library, accessed July 31, 2021, https://pedpalascnetlibrary.omeka.net/items/show/12825.

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