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

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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.

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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.

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Authors and Affiliations

  1. Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA

    Lindsay S. Mayberry

  2. Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TNA, USA

    Lindsay S. Mayberry

  3. Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA

    John D. Piette

  4. VA Center for Clinical Management Research, Ann Arbor, MI, USA

    John D. Piette & Aaron A. Lee

  5. Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA

    James E. Aikens

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  1. Lindsay S. Mayberry
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  2. John D. Piette
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Correspondence to Lindsay S. Mayberry.

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

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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.

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Mayberry, L.S., Piette, J.D., Lee, A.A. et al. Out-of-home informal support important for medication adherence, diabetes distress, hemoglobin A1c among adults with type 2 diabetes. J Behav Med 42, 493–501 (2019). https://doi.org/10.1007/s10865-018-0002-0

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