Which Patients with Type 2 Diabetes Will Have Greater Compliance to Participation in the Diabetes Conversation Map™ Program? A Retrospective Cohort Study. Diabetes Research and Clinical Practice, 2018. (Epub ahead of print.)
Srulovici E, Feldman B, Reges O, Hoshen M, Balicer RD, Rotem M, Shadmi E, Key C, Curtis B, He X, Rubin G, Strizek A, Leventer-Roberts M.
Aim: To investigate the characteristics of participants in the Diabetes Conversation Map™ (Map™) program who had higher vs. lower compliance to the program, to determine if program tailoring and monitoring is needed among these groups.
Methods: This was a retrospective cohort study of 8,990 patients enrolled in the Map™ program (low compliance [attending 0-1 sessions, n=2,759] and high compliance [attending ≥2 sessions, n=6,231]). Socio-demographic, clinical, health behaviors, and healthcare utilization characteristics were extracted. Multivariable stepwise logistic regression was used as the analysis strategy.
Results: Those who were of higher socio-economic status (OR=1.567, 95%CI:1.317-1.865), who lived in urban area (OR=1.501, 95%CI:1.254-1.798), with greater frequency of primary care visits (OR=1.012, 95%CI:1.002-1.021), with medium (OR=1.176, 95%CI:1.013-1.365) or high oral medication adherence (OR=1.198, 95%CI:1.059-1.356), and with a greater frequency of blood glucose tests (OR=1.102, 95%CI:1.033-1.175) had greater odds of being in the high compliance group. Conversely, those aged 35-44 (OR=0.538, 95%CI:0.402-0.721) and 45-54 years (OR=0.763, 95%CI:0.622-0.937), with longer Type 2 diabetes duration (OR=0.980, 95%CI:0.967-0.993), with higher blood glucose levels (OR=0.999, 95%CI:0.998-1.000), and current (OR=0.659, 95%CI:0.569-0.762) or former smokers (OR=0.831, 95%CI:0.737-0.938) had reduced odds for being in the higher compliance group.
Conclusions: Instructors in advance can target sub-groups to increase their attendance rates, and consequently improve their outcomes.