Top

International Journal of Behavioral Medicine

Published in:

01-08-2021 | Dyslipidemia | Full length manuscript

Effect of Changes in Patient’s Self-management Strategies on Clinical Outcomes: Evidence from a Cohort Study of Patients with Diabetes, Hypertension, and Hyperlipidemia

Authors: EunKyo Kang, Kyae Hyung Kim, Young Min Cho, Sang Min Park, Yong-Jin Kim, Hae-Young Lee, Ye Eun Rhee, Soojeong Kim, Young Ho Yun

Published in: International Journal of Behavioral Medicine | Issue 4/2021

Abstract

Background

Self-management has become the dominant care model for chronic disease management. This study aimed to investigate the effect of changes in self-management strategies on the clinical outcomes of chronic diseases.

Methods

Two hundred ninety-seven patients with one or more chronic disease (diabetes, dyslipidemia, or hypertension) were registered and followed in this prospective cohort study. We compared differences in the changes in clinical outcomes from baseline to 6 months according to the improvement of self-management strategies by analysis of covariance.

Results

Diabetic patients with improved self-management strategies showed a significantly greater change in HbA1c levels compared to patients without improvement of self-management strategies (group difference in HbA1c = 0.51%). In hypertensive patients, systolic and diastolic blood pressure (BP) showed a significant decline in the patients with improved self-management strategies (group difference in systolic BP = 6.2 mmHg and in diastolic BP = 5.5 mmHg). Clinical outcomes improved significantly when self-management strategies improved in people with a poor self-management strategy at baseline.

Conclusions

This study suggests that improvements in self-management strategies are associated with an improvement in clinical outcomes among patients with chronic diseases, especially for those with an initially poor self-management strategy.

Available only for authorised users

WHO. Global status report on noncommunicable diseases 2010: Geneva: World Health Organization; 2011.

Ferguson T. Consumer health informatics. Healthc Forum J. 1995;38(1):28–33. PubMed

Booth JN 3rd, Levitan EB, Brown TM, Farkouh ME, Safford MM, Muntner P. Effect of sustaining lifestyle modifications (nonsmoking, weight reduction, physical activity, and mediterranean diet) after healing of myocardial infarction, percutaneous intervention, or coronary bypass (from the Reasons for Geographic and Racial Differences in Stroke Study). Am J Cardiol. 2014;113(12):1933–40. https://doi.org/10.1016/j.amjcard.2014.03.033. CrossRefPubMedPubMedCentral

Glasgow RE, Funnell MM, Bonomi AE, Davis C, Beckham V, Wagner EH. Self-management aspects of the improving chronic illness care breakthrough series: implementation with diabetes and heart failure teams. Ann Behav Med. 2002;24(2):80–7. CrossRef

Brown SA, García AA, Brown A, et al. Biobehavioral determinants of glycemic control in type 2 diabetes: A systematic review and meta-analysis. Patient Educ Couns. 2016;99(10):1558–67. https://doi.org/10.1016/j.pec.2016.03.020. CrossRefPubMedPubMedCentral

Peyrot M, Rubin RR. Behavioral and psychosocial interventions in diabetes: a conceptual review. Diabetes Care. 2007;30(10):2433–40. https://doi.org/10.2337/dc07-1222. CrossRefPubMed

den Braver NR, de Vet E, Duijzer G, et al. Determinants of lifestyle behavior change to prevent type 2 diabetes in high-risk individuals. Int J Behav Nutr Phys Act. 2017;14(1):78. https://doi.org/10.1186/s12966-017-0532-9. CrossRef

Beck J, Greenwood DA, Blanton L, et al. 2017 National standards for diabetes self-management education and support. Diabetes Educ. 2018;44(1):35–50. CrossRef

Educators NCBFD. Renewal of Certification by Continuing Education Handbook 2019.

10.

Comprehensive Medical Evaluation and Assessment of Comorbidities. Standards of Medical Care in Diabetes—2019. Diabetes Care. 2019;42(Supplement 1):S34–45. https://doi.org/10.2337/dc19-S004. CrossRef

11.

Yun YH, Jung JY, Sim JA, et al. Patient-reported assessment of self-management strategies of health in cancer patients: development and validation of the Smart Management Strategy for Health Assessment Tool (SAT). Psychooncology. 2015;24(12):1723–30. https://doi.org/10.1002/pon.3839. CrossRefPubMed

12.

Yun YH, Jung JY, Sim JA, et al. Development and validation of the smart management strategy for health assessment tool-short form (SAT-SF) in cancer survivors. Qual Life Res. 2018a;27(2):347–54. https://doi.org/10.1007/s11136-017-1723-1. CrossRefPubMed

13.

14.

Dorresteijn JAN, Graaf Yvd, Spiering W, Grobbee DE, Bots ML, Visseren FLJ. Relation between blood pressure and vascular events and mortality in patients with manifest vascular disease. Hypertension. 2012;59(1):14-21. https://doi.org/10.1161/HYPERTENSIONAHA.111.179143

15.

Yi SW, Park S, Lee YH, Balkau B, Yi JJ. Fasting glucose and all-cause mortality by age in diabetes: a prospective cohort study. Diabetes Care. 2018;41(3):623–6. https://doi.org/10.2337/dc17-1872. CrossRefPubMed

16.

Fujioka K, Brazg RL, Raz I, et al. Efficacy, dose-response relationship and safety of once-daily extended-release metformin (Glucophage XR) in type 2 diabetic patients with inadequate glycaemic control despite prior treatment with diet and exercise: results from two double-blind, placebo-controlled studies. Diabetes Obes Metab. 2005;7(1):28–39. https://doi.org/10.1111/j.1463-1326.2004.00369.x. CrossRefPubMed

17.

Julius S, Kjeldsen SE, Weber M, et al. Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial. The Lancet. 2004;363(9426):2022–31. https://doi.org/10.1016/S0140-6736(04)16451-9. CrossRef

18.

Peterson KA, Hughes M. Readiness to change and clinical success in a diabetes educational program. J Am Board Fam Pract. 2002;15(4):266–71. PubMed

19.

Lorig K, Ritter PL, Turner RM, English K, Laurent DD, Greenberg J. A diabetes self-management program: 12-month outcome sustainability from a nonreinforced pragmatic trial. J Med Internet Res. 2016;18(12):e322. https://doi.org/10.2196/jmir.6484. CrossRefPubMedPubMedCentral

20.

Dickinson HO, Mason JM, Nicolson DJ, et al. Lifestyle interventions to reduce raised blood pressure: a systematic review of randomized controlled trials. J Hypertens. 2006;24(2):215–33. https://doi.org/10.1097/01.hjh.0000199800.72563.26. CrossRefPubMed

21.

McManus RJ, Mant J, Haque MS, et al. Effect of self-monitoring and medication self-titration on systolic blood pressure in hypertensive patients at high risk of cardiovascular disease: the TASMIN-SR randomized clinical trial. JAMA. 2014;312(8):799–808. https://doi.org/10.1001/jama.2014.10057. CrossRefPubMed

22.

Bosworth HB, Powers BJ, Olsen MK, et al. Home blood pressure management and improved blood pressure control: results from a randomized controlled trial. Arch Intern Med. 2011;171(13):1173–80. https://doi.org/10.1001/archinternmed.2011.276. CrossRefPubMed

23.

Martens A, Greenberg J, Allen J, Hayes J, Schimel J, Johns M. Self-esteem and autonomic physiology: Self-esteem levels predict cardiac vagal tone. J Res Pers. 2010;44:573–84. https://doi.org/10.1016/j.jrp.2010.07.001. CrossRef

24.

Edmondson D, Arndt J, Alcantara C, Chaplin W, Schwartz JE. Self-esteem and the acute effect of anxiety on ambulatory blood pressure. Psychosomatic medicine. 2015;77(7):833–41. https://doi.org/10.1097/PSY.0000000000000219. CrossRefPubMedPubMedCentral

25.

Meor Anuar Shuhaili MFR, Samsudin IN, Stanslas J, Hasan S, Thambiah SC. Effects of different types of statins on lipid profile: A perspective on Asians. Int J Endocrinol Metab. 2017;15(2):e43319. doi:https://doi.org/10.5812/ijem.43319

26.

Mensink RP, Zock PL, Kester AD, Katan MB. Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials. Am J Clin Nutr. 2003;77(5):1146–55. https://doi.org/10.1093/ajcn/77.5.1146. CrossRefPubMed

27.

Authors/Task Force M, Catapano AL, Graham I, et al. ESC/EAS Guidelines for the Management of Dyslipidaemias: The Task Force for the Management of Dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) Developed with the special contribution of the European Assocciation for Cardiovascular Prevention & Rehabilitation (EACPR). Atherosclerosis. 2016;2016(253):281–344. https://doi.org/10.1016/j.atherosclerosis.2016.08.018. CrossRef

28.

Chahal N, Rush J, Manlhiot C, Boydell KM, Jelen A, McCrindle BW. Dyslipidemia management in overweight or obese adolescents: A mixed-methods clinical trial of motivational interviewing. SAGE Open Med. 2017;5:2050312117707152. https://doi.org/10.1177/2050312117707152. CrossRefPubMedPubMedCentral

Title: Effect of Changes in Patient’s Self-management Strategies on Clinical Outcomes: Evidence from a Cohort Study of Patients with Diabetes, Hypertension, and Hyperlipidemia
Authors: EunKyo Kang
Kyae Hyung Kim
Young Min Cho
Sang Min Park
Yong-Jin Kim
Hae-Young Lee
Ye Eun Rhee
Soojeong Kim
Young Ho Yun
Publication date: 01-08-2021
Publisher: Springer US
Keywords: Dyslipidemia
Hypertension
Hypertension
Published in: International Journal of Behavioral Medicine / Issue 4/2021
Print ISSN: 1070-5503
Electronic ISSN: 1532-7558
DOI: https://doi.org/10.1007/s12529-020-09937-x

At a glance: The STEP trials

Springer Medicine

Effect of Changes in Patient’s Self-management Strategies on Clinical Outcomes: Evidence from a Cohort Study of Patients with Diabetes, Hypertension, and Hyperlipidemia

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 4/2021

Motivational Interviewing for Weight Management Among Women: a Meta-Analysis and Systematic Review of RCTs

Open-Label Placebo Treatment: Outcome Expectations and General Acceptance in the Lay Population

A Cross-sectional Study of Attention Bias for Facial Expression Stimulation in Patients with Stroke at the Convalescence Stage

Correction to: Tobacco Use and Health-Related Quality of Life Among Individuals with Depression Who Are Receiving Treatment for HIV in Cape Town, South Africa

Changes in Identification of Possible Pain Coping Strategies by People with Osteoarthritis who Complete Web-based Pain Coping Skills Training

Correction to: Influence of a Planning Intervention on Physical Activity Behavior: The Moderating Role of Intentions and Executive Functions in a Randomized Controlled Trial