Cargando…

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

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, de...

Descripción completa

Detalles Bibliográficos
Autores principales: Dambha-Miller, Hajira, Cooper, Andrew J M, Simmons, Rebecca K, Kinmonth, Ann Louise, Griffin, Simon J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4716169/
https://www.ncbi.nlm.nih.gov/pubmed/26739725
http://dx.doi.org/10.1136/bmjopen-2015-008931
_version_ 1782410514439077888
author Dambha-Miller, Hajira
Cooper, Andrew J M
Simmons, Rebecca K
Kinmonth, Ann Louise
Griffin, Simon J
author_facet Dambha-Miller, Hajira
Cooper, Andrew J M
Simmons, Rebecca K
Kinmonth, Ann Louise
Griffin, Simon J
author_sort Dambha-Miller, Hajira
collection PubMed
description 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.
format Online
Article
Text
id pubmed-4716169
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-47161692016-01-31 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 Dambha-Miller, Hajira Cooper, Andrew J M Simmons, Rebecca K Kinmonth, Ann Louise Griffin, Simon J BMJ Open Cardiovascular Medicine 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. BMJ Publishing Group 2016-01-06 /pmc/articles/PMC4716169/ /pubmed/26739725 http://dx.doi.org/10.1136/bmjopen-2015-008931 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
spellingShingle Cardiovascular Medicine
Dambha-Miller, Hajira
Cooper, Andrew J M
Simmons, Rebecca K
Kinmonth, Ann Louise
Griffin, Simon J
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
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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4716169/
https://www.ncbi.nlm.nih.gov/pubmed/26739725
http://dx.doi.org/10.1136/bmjopen-2015-008931
work_keys_str_mv AT dambhamillerhajira patientcentredcarehealthbehavioursandcardiovascularriskfactorlevelsinpeoplewithrecentlydiagnosedtype2diabetes5yearfollowupoftheadditionplustrialcohort
AT cooperandrewjm patientcentredcarehealthbehavioursandcardiovascularriskfactorlevelsinpeoplewithrecentlydiagnosedtype2diabetes5yearfollowupoftheadditionplustrialcohort
AT simmonsrebeccak patientcentredcarehealthbehavioursandcardiovascularriskfactorlevelsinpeoplewithrecentlydiagnosedtype2diabetes5yearfollowupoftheadditionplustrialcohort
AT kinmonthannlouise patientcentredcarehealthbehavioursandcardiovascularriskfactorlevelsinpeoplewithrecentlydiagnosedtype2diabetes5yearfollowupoftheadditionplustrialcohort
AT griffinsimonj patientcentredcarehealthbehavioursandcardiovascularriskfactorlevelsinpeoplewithrecentlydiagnosedtype2diabetes5yearfollowupoftheadditionplustrialcohort