Advertisement

Journal of Behavioral Medicine

, Volume 42, Issue 3, pp 493–501 | Cite as

Out-of-home informal support important for medication adherence, diabetes distress, hemoglobin A1c among adults with type 2 diabetes

  • Lindsay S. MayberryEmail author
  • John D. Piette
  • Aaron A. Lee
  • James E. Aikens
Article
  • 151 Downloads

Abstract

Adults with type 2 diabetes mellitus (T2DM) often receive self-management support from adult children, siblings or close friends residing outside of their home. However, the role of out-of-home support in patients’ self-management and well-being is unclear. Patients (N = 313) with HbA1c > 7.5% were recruited from community primary care clinics for a mobile health intervention trial and identified an out-of-home informal support person, herein called a CarePartner; 38% also had an in-home supporter. We tested cross-sectional adjusted associations between CarePartner relationship characteristics and patients’ self-management, diabetes distress, and HbA1c and whether having an in-home supporter modified these associations. Greater CarePartner closeness was associated with a greater odds of perfect medication adherence (AOR = 1.19, p = .029), more fruit/vegetable intake (β = 0.14, p = .018), and lower diabetes distress (β = − 0.14, p = .012). More frequent CarePartner contact was associated with better HbA1c among patients with an in-home supporter but with worse HbA1c among patients without an in-home supporter (interaction β = − 0.45, p = .005). Emotional closeness with a CarePartner may be important for supporting T2DM self-management and reducing diabetes distress. CarePartners may appropriately engage more frequently when patients with no in-home supporter have poorly controlled diabetes.

Keywords

Disease self-management Informal caregivers Family Social support Type 2 diabetes Glycemic control 

Notes

Funding

This research was funded by NIH/NIDDK Grant R18DK88294-01 and used resources from the Michigan Center for Diabetes Translational Research supported by DK92926. Dr. Mayberry was supported by career development award NIH/NIDDK K01-DK106306.

Compliance with ethical standards

Conflict of interest

Lindsay S. Mayberry, John D. Piette, Aaron A. Lee and James E. Aikens declare that they have no conflict of interest.

Human and animal rights and Informed consent

All procedures were in accordance with the ethical standards of the institutional research committees and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

References

  1. American Diabetes Association. (2018). Economic costs of diabetes in the U.S. in 2017. Diabetes care.  https://doi.org/10.2337/dci18-0007 Google Scholar
  2. Baek, R. N., Tanenbaum, M. L., & Gonzalez, J. S. (2014). Diabetes burden and diabetes distress: The buffering effect of social support. Annals of Behavioral Medicine, 48, 145–155.CrossRefGoogle Scholar
  3. Bowen, D. J., Helmes, A., & Lease, E. (2001). Predicting compliance: How are we doing? In L. Burke & I. Ockene (Eds.), Compliance in healthcare and research (pp. 25–41). Armonk: Futura.Google Scholar
  4. Burner, E., Lam, C. N., DeRoss, R., Kagawa-Singer, M., Menchine, M., & Arora, S. (2018). Using mobile health to improve social support for low-income Latino patients with diabetes: A mixed-methods analysis of the feasibility trial of TExT-MED + FANS. Diabetes Technology & Therapeutics, 20, 39–48.CrossRefGoogle Scholar
  5. Burns, K. K., Nicolucci, A., Holt, R., Willaing, I., Hermanns, N., Kalra, S., et al. (2013). Educational and Psychological Issues Diabetes Attitudes, Wishes and Needs Second Study (DAWN2TM): Cross-national benchmarking indicators for family members living with people with diabetes. Diabetic Medicine, 30, 778–788.CrossRefGoogle Scholar
  6. Centers for Disease Control and Prevention. (2017). National diabetes statistics report, 2017: Estimates of diabetes and its Burden in the United States. Retrieved November 11, 2018 from https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf
  7. Cohen, S., & Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98, 310–357.CrossRefGoogle Scholar
  8. DiMatteo, M. R. (2004a). Social support and patient adherence to medical treatment: A meta-analysis. Health Psychology, 23, 207–218.CrossRefGoogle Scholar
  9. DiMatteo, M. R. (2004b). Variations in patients’ adherence to medical recommendations: A quantitative review of 50 years of research. Medical Care, 42, 200–209.CrossRefGoogle Scholar
  10. Fisher, L., Chesla, C. A., Bartz, R. J., Gilliss, C., Skaff, M. A., Sabogal, F., et al. (1998). The family and type 2 diabetes: A framework for intervention. Diabetes Educator, 24, 599–607.CrossRefGoogle Scholar
  11. Fisher, L., Chesla, C. A., Skaff, M. M., Gilliss, C., Mullan, J., Bartz, R. J., et al. (2000). The family and disease management in Hispanic and European-American patients with type 2 diabetes. Diabetes Care, 23, 267–272.CrossRefGoogle Scholar
  12. Fisher, L., Hessler, D. M., Polonsky, W., & Mullan, J. (2012). When is diabetes distress clinically meaningful?: Establishing cut points for the diabetes distress scale. Diabetes Care, 35, 259–264.CrossRefGoogle Scholar
  13. Fisher, L., Skaff, M., Mullan, J., Arean, P., Glasgow, R., & Masharani, U. (2008). A longitudinal study of affective and anxiety disorders, depressive affect and diabetes distress in adults with type 2 diabetes. Diabetic Medicine, 25, 1096–1101.CrossRefGoogle Scholar
  14. Glasgow, R. E., & Toobert, D. J. (1988). Social environment and regimen adherence among type II diabetic patients. Diabetes Care, 11, 377–386.CrossRefGoogle Scholar
  15. Graham, J. (2009). Missing data analysis: Making it work in the real world. Annual Review of Psychology, 60, 549–576.CrossRefGoogle Scholar
  16. Hayes, A. F., & Cai, L. (2007). Using heteroskedasticity-consistent standard error estimators in OLS regression: An introduction and software implementation. Behavior Research Methods, 39, 709–722.CrossRefGoogle Scholar
  17. Herman, W. H., Dungan, K. M., Wolffenbuttel, B. H., Buse, J. B., Fahrbach, J. L., Jiang, H., et al. (2009). Racial and ethnic differences in mean plasma glucose, hemoglobin A1c, and 1, 5-anhydroglucitol in over 2000 patients with type 2 diabetes. The Journal of Clinical Endocrinology & Metabolism, 94, 1689–1694.CrossRefGoogle Scholar
  18. Jacobson, D. E. (1986). Types and timing of social support. Journal of Health and Social Behavior, 27, 250–264.CrossRefGoogle Scholar
  19. Jones, H., Edwards, L., Vallis, T. M., Ruggiero, L., Rossi, S. R., Rossi, J., et al. (2003). Changes in diabetes self-care behaviors make a difference in glycemic control—The diabetes stages of change (DiSC) study. Diabetes Care, 26, 732–737.CrossRefGoogle Scholar
  20. Kirk, J. K., D’Agostino, R. B., Bell, R. A., Passmore, L. V., Bonds, D. E., Karter, A. J., et al. (2006). Disparities in HbA1c levels between African–American and non-Hispanic white adults with diabetes: A meta-analysis. Diabetes Care, 29, 2130–2136.CrossRefGoogle Scholar
  21. Lee, A., Piette, J. D., Heisler, M., Janevic, M., Langa, K. M., & Rosland, A. M. (2017). Family members’ experiences supporting adults with chronic illness: A national survey. Families, Systems & Health, 35, 463.CrossRefGoogle Scholar
  22. Little, R. J., D’Agostino, R., Cohen, M. L., Dickersin, K., Emerson, S. S., Farrar, J. T., et al. (2012). The prevention and treatment of missing data in clinical trials. New England Journal of Medicine, 367, 1355–1360.CrossRefGoogle Scholar
  23. Mayberry, L. S., Berg, C. A., Harper, K. J., & Osborn, C. Y. (2016). The design, usability, and feasibility of a family-focused diabetes self-care support mHealth intervention for diverse, low-income adults with type 2 diabetes. Journal of Diabetes Research, 2016, 7586385.CrossRefGoogle Scholar
  24. Mayberry, L. S., Bergner, E. M., Chakkalakal, R. J., Elasy, T. A., & Osborn, C. Y. (2016). Self-care disparities among adults with type 2 diabetes in the USA. Current Diabetes Repoirts, 16, 113.CrossRefGoogle Scholar
  25. Mayberry, L. S., Kripalani, S., Rothman, R. L., & Osborn, C. Y. (2011). Bridging the digital divide in diabetes: Family support and implications for health literacy. Diabetes technology & therapeutics, 13, 1005–1012.CrossRefGoogle Scholar
  26. Mayberry, L. S., & Osborn, C. Y. (2012). Family support, medication adherence, and glycemic control among adults with type 2 diabetes. Diabetes Care, 35, 1239–1245.  https://doi.org/10.2337/dc11-2103 CrossRefGoogle Scholar
  27. Mayberry, L. S., & Osborn, C. Y. (2014). Family involvement is helpful and harmful to patients’ self-care and glycemic control. Patient Education and Counseling, 97, 418–425.CrossRefGoogle Scholar
  28. Nicklett, E. J., Heisler, M. E. M., Spencer, M. S., & Rosland, A. M. (2013). Direct social support and long-term health among middle-aged and older adults with type 2 diabetes mellitus. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 68, 933–943.CrossRefGoogle Scholar
  29. Piette, J. D., Rosland, A. M., Silveira, M., Kabeto, M., & Langa, K. M. (2010). The case for involving adult children outside of the household in the self-management support of older adults with chronic illnesses. Chronic illness, 6, 34–45.CrossRefGoogle Scholar
  30. Piette, J. D., Sen, A., & Aikens, J. E. (2014). Randomized controlled trial of mhealth telemonitoring with enhanced caregiver support for diabetes self-management. Journal of Clinical Trials, 4, 1000194.Google Scholar
  31. Polonsky, W. H., Fisher, L., Earles, J., Dudl, R. J., Lees, J., Mullan, J., et al. (2005). Assessing psychosocial distress in diabetes development of the diabetes distress scale. Diabetes Care, 28, 626–631.CrossRefGoogle Scholar
  32. Rodriguez, M. S., & Cohen, S. (1998). Social support. Encyclopedia of Mental Health, 3, 535–544.Google Scholar
  33. Rosland, A. M., Heisler, M., Choi, H. J., Silveira, M. J., & Piette, J. D. (2010). Family influences on self-management among functionally independent adults with diabetes or heart failure: Do family members hinder as much as they help? Chronic Illness, 6, 22–33.CrossRefGoogle Scholar
  34. Rosland, A. M., Heisler, M., Janevic, M. R., Connell, C. M., Langa, K. M., Kerr, E. A., et al. (2013). Current and potential support for chronic disease management in the United States: The perspective of family and friends of chronically ill adults. Families, Systems, & Health, 31, 119.CrossRefGoogle Scholar
  35. Rosland, A. M., Heisler, M., & Piette, J. D. (2012). The impact of family behaviors and communication patterns on chronic illness outcomes: A systematic review. Journal of Behavioral Medicine, 35, 221–239.CrossRefGoogle Scholar
  36. Schiøtz, M., Bøgelund, M., Almdal, T., Jensen, B., & Willaing, I. (2012). Social support and self-management behaviour among patients with type 2 diabetes. Diabetic Medicine, 29, 654–661.CrossRefGoogle Scholar
  37. Selvin, E., Parrinello, C. M., Sacks, D. B., & Coresh, J. (2014). Trends in prevalence and control of diabetes in the United States, 1988–1994 and 1999–2010. Annals of Internal Medicine, 160, 517–525.CrossRefGoogle Scholar
  38. Silliman, R. A., Bhatti, S., Khan, A., Dukes, K. A., & Sullivan, L. M. (1996). The care of older persons with diabetes mellitus: Families and primary care physicians. Journal of the American Geriatrics Society, 44, 1314–1321.CrossRefGoogle Scholar
  39. Stephens, M. A. P., Franks, M. M., Rook, K. S., Iida, M., Hemphill, R. C., & Salem, J. K. (2013). Spouses’ attempts to regulate day-to-day dietary adherence among patients with type 2 diabetes. Health Psychology, 32, 1029.CrossRefGoogle Scholar
  40. Stirratt, M. J., Dunbar-Jacob, J., Crane, H. M., Simoni, J. M., Czajkowski, S., Hilliard, M. E., et al. (2015). Self-report measures of medication adherence behavior: Recommendations on optimal use. Translational Behavioral Medicine, 5, 470–482.CrossRefGoogle Scholar
  41. Svarstad, B. L., Chewning, B. A., Sleath, B. L., & Claesson, C. (1999). The brief medication questionnaire: A tool for screening patient adherence and barriers to adherence. Patient Education and Counseling, 37, 113–124.CrossRefGoogle Scholar
  42. Tang, T. S., Brown, M. B., Funnell, M. M., & Anderson, R. M. (2008). Social support, quality of life, and self-care behaviors among African Americans with type 2 diabetes. Diabetes Educator, 34, 266–276.CrossRefGoogle Scholar
  43. The Diabetes Care and Complications Trial Research Group. (1993). Effect of intensive diabetes treatment on the development and progression of long-term complications in insulin-dependent diabetes mellitus. New England Journal of Medicine, 329, 977–986.CrossRefGoogle Scholar
  44. Thoits, P. A. (2011). Mechanisms linking social ties and support to physical and mental health. Journal of Health and Social Behavior, 52, 145–161.  https://doi.org/10.1177/0022146510395592 CrossRefGoogle Scholar
  45. Toobert, D. J., Hampson, S. E., & Glasgow, R. E. (2000). The Summary of Diabetes Self-Care Activities measure: Results from 7 studies and a revised scale. Diabetes Care, 23, 943–950.CrossRefGoogle Scholar
  46. UK Prospective Diabetes Study Group. (1998). Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet, 352, 837–853.CrossRefGoogle Scholar
  47. United States Census Bureau. Historical poverty tables: People and families—1959–2017. Table 1 weighted average poverty thresholds for families of specified size. Retrieved November 11, 2018 from https://www.census.gov/data/tables/time-series/demo/income-poverty/historical-poverty-people.html
  48. US Department of Health and Human Services Administration on Aging. (2017). 2017 Profile of older Americans. Retrieved November 11, 2018 from https://www.acl.gov/sites/default/files/Aging%20and%20Disability%20in%20America/2017OlderAmericansProfile.pdf
  49. Vongmany, J., Luckett, T., Lam, L., & Phillips, J. (2018). Family behaviours that have an impact on the self-management activities of adults living with type 2 diabetes: A systematic review and meta-synthesis. Diabetic Medicine, 35, 184–194.CrossRefGoogle Scholar
  50. Weinstock, R. S., Teresi, J. A., Goland, R., Izquierdo, R., Palmas, W., Eimicke, J. P., Consortium, I. (2011). Glycemic control and health disparities in older ethnically diverse underserved adults with diabetes: Five-year results from the Informatics for Diabetes Education and Telemedicine (IDEATel) study. Diabetes Care, 34, 274–279.CrossRefGoogle Scholar
  51. Weiss, R. S. (1976). Transition states and other stressful situations: Their nature and programs for their management (pp. 213–232). Support systems and mutual help: Multidisciplinary explorations.Google Scholar
  52. Wen, L. K., Shepherd, M. D., & Parchman, M. L. (2004). Family support, diet, and exercise among older Mexican Americans with type 2 diabetes. The Diabetes Educator, 30, 980–993.CrossRefGoogle Scholar
  53. Wolff, J. L., Darer, J. D., & Larsen, K. L. (2016). Family caregivers and consumer health information technology. Journal of General Internal Medicine, 31, 117–121.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of MedicineVanderbilt University Medical CenterNashvilleUSA
  2. 2.Center for Health Behavior and Health EducationVanderbilt University Medical CenterNashvilleUSA
  3. 3.Department of Health Behavior and Health EducationUniversity of MichiganAnn ArborUSA
  4. 4.VA Center for Clinical Management ResearchAnn ArborUSA
  5. 5.Department of Family MedicineUniversity of MichiganAnn ArborUSA

Personalised recommendations