Integrating support persons into diabetes telemonitoring to improve self-management and medication adherence.
J Gen Intern Med
; 30(3): 319-26, 2015 Mar.
Article
em En
| MEDLINE
| ID: mdl-25421436
ABSTRACT
OBJECTIVE:
The purpose of this study was to investigate the potential benefits for medication adherence of integrating a patient-selected support person into an automated diabetes telemonitoring and self-management program, and to determine whether these benefits vary by patients' baseline level of psychological distress. STUDYDESIGN:
The study was a quasi-experimental patient preference trial.METHODS:
The study included patients with type 2 diabetes who participated in three to six months of weekly automated telemonitoring via interactive voice response (IVR) calls, with the option of designating a supportive relative or friend to receive automated updates on the patient's health and self-management, along with guidance regarding potential patient assistance. We measured long-term medication adherence using the four-point Morisky Medication Adherence Scale (MMAS-4, possible range 0-4), weekly adherence with an IVR item, and psychological distress at baseline with the Mental Composite Summary (MCS) of the SF-12.RESULTS:
Of 98 initially nonadherent patients, 42% opted to involve a support person. Participants with a support person demonstrated significantly greater improvement in long-term adherence than those who participated alone (linear regression slopes -1.17 vs. -0.57, respectively, p =0.001). Among distressed patients in particular, the odds of weekly nonadherence tended to decrease 25% per week for those with a support person (p =0.030), yet remained high for those who participated alone (p =0.820).CONCLUSIONS:
Despite their multiple challenges in illness self-management, patients with diabetes who are both nonadherent and psychologically distressed may benefit by the incorporation of a support person when they receive assistance via automated telemonitoring.
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Base de dados:
MEDLINE
Assunto principal:
Autocuidado
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Apoio Social
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Telemedicina
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Gerenciamento Clínico
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Diabetes Mellitus Tipo 2
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Adesão à Medicação
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article