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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

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
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, 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; Postresults.

2044-6055
1-7
Dambha-Miller, Hajira
58961db5-31aa-460e-9394-08590c4b7ba1
Cooper, Andrew J.M.
d1ceb85a-3ef1-4fe5-bbfa-6fde10d1c32c
Simmons, Rebecca K.
3430aa3e-0728-43b0-a3ab-21f6ab5de794
Kinmonth, Ann Louise
bb512425-d66c-488f-b9d2-ed897bdcb73a
Griffin, Simon J.
1f8d5095-3c10-4973-a2c4-84ce6415d118
Dambha-Miller, Hajira
58961db5-31aa-460e-9394-08590c4b7ba1
Cooper, Andrew J.M.
d1ceb85a-3ef1-4fe5-bbfa-6fde10d1c32c
Simmons, Rebecca K.
3430aa3e-0728-43b0-a3ab-21f6ab5de794
Kinmonth, Ann Louise
bb512425-d66c-488f-b9d2-ed897bdcb73a
Griffin, Simon J.
1f8d5095-3c10-4973-a2c4-84ce6415d118

Dambha-Miller, Hajira, Cooper, Andrew J.M., Simmons, Rebecca K., Kinmonth, Ann Louise and Griffin, Simon J. (2016) 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. BMJ Open, 6 (1), 1-7, [e008931]. (doi:10.1136/bmjopen-2015-008931).

Record type: Article

Abstract

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; Postresults.

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Accepted/In Press date: 26 October 2015
Published date: 1 January 2016

Identifiers

Local EPrints ID: 433420
URI: http://eprints.soton.ac.uk/id/eprint/433420
ISSN: 2044-6055
PURE UUID: 887b5700-77b5-4a6a-91ff-c5215be0824d
ORCID for Hajira Dambha-Miller: ORCID iD orcid.org/0000-0003-0175-443X

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Date deposited: 21 Aug 2019 16:30
Last modified: 07 Oct 2020 02:23

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Contributors

Author: Andrew J.M. Cooper
Author: Rebecca K. Simmons
Author: Ann Louise Kinmonth
Author: Simon J. Griffin

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