Title |
Patient-centred care, health behaviours and cardiovascular risk factor levels in people with recently diagnosed type 2 diabetes: 5-year follow-up of the ADDITION-Plus trial cohort
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Published in |
BMJ Open, January 2016
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DOI | 10.1136/bmjopen-2015-008931 |
Pubmed ID | |
Authors |
Hajira Dambha-Miller, Andrew J M Cooper, Rebecca K Simmons, Ann Louise Kinmonth, Simon J Griffin, Ruhul Amin, Gisela Baker, Mark Betts, Adam Dickinson, Justin Basile Echouffo Tcheugui, Ulf Ekelund, Francis Finucane, Stefanie Mayle, Joanna Mitchell, Paul Roberts, Lincoln Sargeant, Matt Sims, Nick Wareham, Fiona Whittle, Judith Argles, Rebecca Bale, Roslyn Barling, Sue Boase, James Brimicombe, Ryan Butler, Tom Fanshawe, Philippa Gash, Julie Grant, Wendy Hardeman, Imogen Hobbis, Tom McGonigle, Nicola Popplewell, Jenny Smith, Megan Smith, Stephen Sutton, Fiona Whittle, Kate Williams |
Abstract |
To examine the association between the experience of patient-centred care (PCC), health behaviours and cardiovascular disease (CVD) risk factor levels among people with type 2 diabetes. Population-based prospective cohort study. 34 general practices in East Anglia, UK, delivering organised diabetes care. 478 patients recently diagnosed with type 2 diabetes aged between 40 and 69 years enrolled in the ADDITION-Plus trial. Self-reported and objectively measured health behaviours (diet, physical activity, smoking status), CVD risk factor levels (blood pressure, lipid levels, glycated haemoglobin, body mass index, waist circumference) and modelled 10-year CVD risk. Better experiences of PCC early in the course of living with diabetes were not associated with meaningful differences in self-reported physical activity levels including total activity energy expenditure (β-coefficient: 0.080 MET h/day (95% CI 0.017 to 0.143; p=0.01)), moderate-to-vigorous physical activity (β-coefficient: 5.328 min/day (95% CI 0.796 to 9.859; p=0.01)) and reduced sedentary time (β-coefficient: -1.633 min/day (95% CI -2.897 to -0.368; p=0.01)). PCC was not associated with clinically meaningful differences in levels of high-density lipoprotein cholesterol (β-coefficient: 0.002 mmol/L (95% CI 0.001 to 0.004; p=0.03)), systolic blood pressure (β-coefficient: -0.561 mm Hg (95% CI -0.653 to -0.468; p=0.01)) or diastolic blood pressure (β-coefficient: -0.565 mm Hg (95% CI -0.654 to -0.476; p=0.01)). Over an extended follow-up of 5 years, we observed no clear evidence that PCC was associated with self-reported, clinical or biochemical outcomes, except for waist circumference (β-coefficient: 0.085 cm (95% CI 0.015 to 0.155; p=0.02)). We found little evidence that experience of PCC early in the course of diabetes was associated with clinically important changes in health-related behaviours or CVD risk factors. ISRCTN99175498; Post-results. |
X Demographics
Geographical breakdown
Country | Count | As % |
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United Kingdom | 1 | 25% |
Spain | 1 | 25% |
Unknown | 2 | 50% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 4 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 161 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Bachelor | 29 | 18% |
Student > Master | 16 | 10% |
Researcher | 15 | 9% |
Student > Ph. D. Student | 12 | 7% |
Student > Postgraduate | 8 | 5% |
Other | 29 | 18% |
Unknown | 52 | 32% |
Readers by discipline | Count | As % |
---|---|---|
Nursing and Health Professions | 27 | 17% |
Medicine and Dentistry | 26 | 16% |
Sports and Recreations | 14 | 9% |
Psychology | 9 | 6% |
Social Sciences | 6 | 4% |
Other | 21 | 13% |
Unknown | 58 | 36% |