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
{"title":"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。","authors":"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","doi":"10.1111/dme.15412","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aims</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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 (<i>β</i> = −0.23, SE = 0.12, <i>p</i> < 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 (<i>β</i> = −0.11, SE = 0.21, <i>p</i> = 0.34) compared with those who did not receive a reminder (<i>β</i> = −0.62, SE = 0.08, <i>p</i> < 0.01).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>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.</p>\n </section>\n </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"41 12","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11560630/pdf/","citationCount":"0","resultStr":"{\"title\":\"Factors influencing diabetes treatment satisfaction in the INtegrating DEPrEssioN and Diabetes treatmENT randomized clinical trial: A multilevel model analysis\",\"authors\":\"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\",\"doi\":\"10.1111/dme.15412\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Aims</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>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 (<i>β</i> = −0.23, SE = 0.12, <i>p</i> < 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 (<i>β</i> = −0.11, SE = 0.21, <i>p</i> = 0.34) compared with those who did not receive a reminder (<i>β</i> = −0.62, SE = 0.08, <i>p</i> < 0.01).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Increased burden of depressive symptoms influences diabetes care satisfaction. 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Factors influencing diabetes treatment satisfaction in the INtegrating DEPrEssioN and Diabetes treatmENT randomized clinical trial: A multilevel model analysis
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.
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.”
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