Factors influencing diabetes treatment satisfaction in the INtegrating DEPrEssioN and Diabetes treatmENT randomized clinical trial: A multilevel model analysis.

IF 3.2 3区医学 Q2 ENDOCRINOLOGY & METABOLISM Diabetic Medicine Pub Date : 2024-12-01 Epub Date: 2024-07-22 DOI:10.1111/dme.15412

Zach Cooper, Leslie Johnson, Mohammed K Ali, Shivani A Patel, Subramani Poongothai, Viswanathan Mohan, R M Anjana, N Tandon, R Khadgawat, G R Sridhar, S R Aravind, B Sosale, R Sagar, Radha Shankar, Bhavani Sundari, Madhu Kosari, K M Venkat Narayan, Deepa Rao, Lydia Chwastiak

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Abstract

Aims: Patient satisfaction is associated with positive diabetes outcomes. However, there are no identified studies that evaluate both patient- and clinic-level predictors influencing diabetes care satisfaction longitudinally.

Methods: Data from the INtegrating DEPrEssioN and Diabetes treatmENT trial was used to perform the analysis. We used fixed and random effects models to assess whether and how changes in patient-level predictors (treatment assignment, depression symptom severity, systolic blood pressure, body mass index, LDL cholesterol, and haemoglobin A1C) from 0 to 24 months and clinic-level predictors (visit frequency, visit cost, number of specialists, wait time, time spent with healthcare provider, and receiving verbal reminders) measured at 24 months influence diabetes care satisfaction from 0 to 24 months.

Results: Model 1 (patient-level predictors) accounted for 7% of the change in diabetes satisfaction and there was a significant negative relationship between change in depressive symptoms and care satisfaction (β = -0.23, SE = 0.12, p < 0.05). Within Model 1, 2% of the variance was explained by clinic-level predictors. Model 2 included both patient- and clinic-level predictors and accounted for 18% of the change in diabetes care satisfaction. Within Model 2, 9% of the variance was attributed to clinic-level predictors. There was also a cross-level interaction where the change in depression had less of an impact on the change in satisfaction for those who received a verbal reminder (β = -0.11, SE = 0.21, p = 0.34) compared with those who did not receive a reminder (β = -0.62, SE = 0.08, p < 0.01).

Conclusions: Increased burden of depressive symptoms influences diabetes care satisfaction. Clinic-level predictors also significantly influence diabetes care satisfaction and can reduce dissatisfaction in primary care, specifically, reminder calls from clinic staff.

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糖尿病治疗与糖尿病治疗整合随机临床试验中影响糖尿病治疗满意度的因素：多层次模型分析。

目的：患者满意度与积极的糖尿病治疗结果相关。然而，目前还没有发现对影响糖尿病护理满意度的患者和诊所层面的预测因素进行纵向评估的研究：方法：我们使用了 "整合DEPrEssioN和糖尿病治疗 "试验的数据进行分析。我们使用固定效应和随机效应模型来评估患者层面的预测因素（治疗分配、抑郁症状严重程度、收缩压、体重指数、低密度脂蛋白胆固醇和血红蛋白A1C）从0个月到24个月的变化以及诊所层面的预测因素（就诊频率、就诊费用、专家数量、等待时间、与医疗服务提供者共处的时间以及接受口头提醒）在24个月时的变化是否会影响糖尿病护理满意度，以及如何影响：模型 1（患者层面的预测因素）占糖尿病满意度变化的 7%，抑郁症状的变化与护理满意度之间存在显著的负相关关系（β = -0.23，SE = 0.12，P 结论：抑郁症状负担的增加会影响糖尿病护理满意度：抑郁症状负担的增加会影响糖尿病护理满意度。诊所层面的预测因素也会对糖尿病护理满意度产生重大影响，尤其是诊所工作人员的提醒电话，可以降低初级护理中的不满意度。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetic Medicine 医学-内分泌学与代谢

CiteScore

7.20

自引率

5.70%

发文量

229

审稿时长

3-6 weeks

期刊介绍： Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions. The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed. We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services. Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”