Reductions in regimen distress are associated with improved management and glycemic control over time.

Abstract:

:OBJECTIVE Cross-sectional and longitudinal associations among regimen distress (RD), self-management, and glycemic control were undertaken to explore mechanisms of operation among these variables. RESEARCH DESIGN AND METHODS In a behavioral randomized control trial (RCT) to reduce RD, 392 adults with type 2 diabetes were assessed for RD, diet, exercise, medication adherence, and HbA1c at baseline and at 4 and 12 months. Associations among RD, self-management, and HbA1c were examined in cross-sectional analyses at baseline, in prospective analyses using baseline values to predict change over time, and in time-varying analyses. RESULTS At baseline, greater RD and poorer medication adherence were independently associated with higher HbA1c (P = 0.05 and P < 0.001, respectively), and greater RD was associated with poorer medication adherence (P = 0.03). No consistent pattern of significant prospective associations was found. Significant time-varying findings showed that decreases in RD were associated with improvements in medication adherence (P < 0.01), physical activity (P < 0.001), and HbA1c (P = 0.02) over time following intervention. Changes in self-management were not associated with changes in HbA1c over time. CONCLUSIONS In the context of an RCT to reduce distress, RD, self-management, and HbA1c were interrelated in cross-sectional and time-varying analyses. Decreases in RD were associated with improvements in both self-management and HbA1c over 12 months. Findings point to the complex and likely multifaceted pathways of association among these key constructs, with results indicating significant linkages between RD and both self-management and glycemic control over time.

journal_name

Diabetes Care

journal_title

Diabetes care

authors

Hessler D,Fisher L,Glasgow RE,Strycker LA,Dickinson LM,Arean PA,Masharani U

doi

10.2337/dc13-0762

subject

Has Abstract

pub_date

2014-01-01 00:00:00

pages

617-24

issue

3

eissn

0149-5992

issn

1935-5548

pii

dc13-0762

journal_volume

37

pub_type

杂志文章,多中心研究,随机对照试验
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    pub_type: 杂志文章,随机对照试验

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    pub_type: 杂志文章,随机对照试验

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    pub_type: 杂志文章,多中心研究,随机对照试验

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    更新日期:2013-12-01 00:00:00

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    pub_type: 临床试验,杂志文章,随机对照试验

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