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. Issue 1 (6th January 2016)

• Record Type: Journal Article
• Authors: Dambha-Miller, Hajira; Cooper, Andrew J M; Simmons, Rebecca K; Kinmonth, Ann Louise; Griffin, Simon J
• Other Names: Amin Ruhul author non-byline.; Baker Gisela author non-byline.; Betts Mark author non-byline.; Dickinson Adam author non-byline.; Tcheugui Justin Basile Echouffo author non-byline.; Ekelund Ulf author non-byline.; Finucane Francis author non-byline.; Mayle Stefanie author non-byline.; Mitchell Joanna author non-byline.; Roberts Paul author non-byline.; Sargeant Lincoln author non-byline.; Sims Matt author non-byline.; Wareham Nick author non-byline.; Whittle Fiona author non-byline.; Argles Judith author non-byline.; Bale Rebecca author non-byline.; Barling Roslyn author non-byline.; Boase Sue author non-byline.; Brimicombe James author non-byline.; Butler Ryan author non-byline.; Fanshawe Tom author non-byline.; Gash Philippa author non-byline.; Grant Julie author non-byline.; Hardeman Wendy author non-byline.; Hobbis Imogen author non-byline.; McGonigle Tom author non-byline.; Popplewell Nicola author non-byline.; Smith Jenny author non-byline.; Smith Megan author non-byline.; Sutton Stephen author non-byline.; Whittle Fiona author non-byline.; Williams Kate author non-byline.;
• Is Part Of: BMJ open. Volume 6:Issue 1(2016)
• Publication Date: 2016-01-06
• Subjects: Type 2 diabetes -- PRIMARY CARE -- patient-centred care; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2015-008931
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objective: 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. Design: Population-based prospective cohort study. Setting: 34 general practices in East Anglia, UK, delivering organised diabetes care. Participants: 478 patients recently diagnosed with type 2 diabetes aged between 40 and 69 years enrolled in the ADDITION-Plus trial. Main outcome measures: 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. Results: 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)). Conclusions: 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. Trial registration number: ISRCTN99175498; Post-results.