Joint influence of patient-assessed chronic illness care and patient activation on glycaemic control in type 2 diabetes

Aung, Eindra, Donald, Maria, Williams, Gail M., Coll, Joseph R. and Doi, Suhail A. R. (2015) Joint influence of patient-assessed chronic illness care and patient activation on glycaemic control in type 2 diabetes. International Journal for Quality in Health Care, 27 2: 117-124. doi:10.1093/intqhc/mzv001


Author Aung, Eindra
Donald, Maria
Williams, Gail M.
Coll, Joseph R.
Doi, Suhail A. R.
Title Joint influence of patient-assessed chronic illness care and patient activation on glycaemic control in type 2 diabetes
Journal name International Journal for Quality in Health Care   Check publisher's open access policy
ISSN 1464-3677
1353-4505
Publication date 2015-04-01
Year available 2015
Sub-type Article (original research)
DOI 10.1093/intqhc/mzv001
Open Access Status
Volume 27
Issue 2
Start page 117
End page 124
Total pages 8
Place of publication Cary, NC United States
Publisher Oxford University Press
Collection year 2016
Language eng
Formatted abstract
Objective To examine the association of the Patient Assessment of Chronic Illness Care (PACIC) with glycaemic control and the modulating effect of patient activation on this association.

Design, Setting and Participants A population-based prospective cohort study of people with type 2 diabetes in Queensland, Australia, using data from self-report questionnaires, collected annually from 2008 (N = 3761) to 2010 (N = 3040).

Main Measures Predictors were the 20-item PACIC (dichotomized at the score of 3), and the 13-item Patient Activation Measure (PAM), dichotomized into activation levels 1 and 2 versus levels 3 and 4. Analyses were restricted to participants whose PACIC and PAM categories did not change over 2 years of follow-up. Outcome variable was self-reported HbA1c of ≤7% (53 mmol/mol) versus >7%.

Statistical Analyses An inverse probability-weighted Poisson regression with a log-link function and a binary response outcome variable (HbA1c) was used to obtain risk ratios (RRs), and the interaction between PACIC and PAM was statistically modelled, taking into consideration patient characteristics and baseline glycaemic status.

Results The effect of the PACIC was not seen in the activated participants (adjusted RR: 1.1; 95% CI: 0.96–1.2; P = 0.20) but was strongly observed in participants with low activation (adjusted RR: 2.3; 95% CI: 1.6–3.1; P < 0.001). Similarly, there was a positive association between patient activation and glycaemic control when the PACIC was low (adjusted RR: 1.6; 95% CI: 1.3–2.0; P < 0.001).

Conclusions Better patient-assessed chronic care received consistently over time facilitates achievement of better glycaemic control in patients with low activation.
Keyword PACIC
Patient activation
Glycaemic control
Chronic illness care
Patient experiences
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Public Health Publications
School of Medicine Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 3 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 3 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Tue, 09 Jun 2015, 02:14:54 EST by System User on behalf of School of Public Health