Currently Viewing:
The American Journal of Accountable Care December 2018
The Cost of Not Taking Our Medicine: The Complex Causes and Effects of Low Medication Adherence
Ellen Harrison, MBA, RN, vice president, HMS
Analysis of 2016 Connecticut ACO Medicare Shared Savings Program Data to Identify Opportunities for Population Health Pharmacist Services
Kathryn Steckowych, PharmD; Marie Smith, PharmD; and Yan Zhuang, PhD
Cost of Delivering Centralized and Decentralized Reminder/Recall for Vaccinations to Children and Adolescents in an ACO
Melanie D. Whittington, PhD; Dennis Gurfinkel, MPH; Laura P. Hurley, MD; Steven Lockhart, MPH; Brenda Beaty, MSPH; Miriam Dickinson, PhD; Heather Roth, MA; and Allison Kempe, MD, MPH
Currently Reading
Mental Health and Diabetes Control Among Vulnerable Primary Care Patients
Darrell L. Hudson, PhD, MPH; Melvin S. Blanchard, MD; Cassandra Arroyo-Johnson, PhD, MS; Laurel Milam, MA; Kimberly A. Kaphingst, ScD; and Melody S. Goodman, PhD, MS
Care Management and Cost Burden in Hepatic Encephalopathy
Christina Mattina, BS
Health Plan Strategies for Value-Based Care: Closing Gaps in Care Means Getting Serious About Prevention
Joshua Sclar, MD, MPH, Chief Medical Officer, BioIQ
The Blueprint for Complex Care: Laying the Groundwork to Build a Field Across Sectors
National Center for Complex Health and Social Needs; Center for Health Care Strategies; and Institute for Healthcare Improvement

Mental Health and Diabetes Control Among Vulnerable Primary Care Patients

Darrell L. Hudson, PhD, MPH; Melvin S. Blanchard, MD; Cassandra Arroyo-Johnson, PhD, MS; Laurel Milam, MA; Kimberly A. Kaphingst, ScD; and Melody S. Goodman, PhD, MS
Only 19% of patients in this sample had good diabetes control based on their tested glycated hemoglobin levels. Patients diagnosed with mental health conditions in this study were more likely to have good diabetes control.
ABSTRACT

Objectives: Patients who have mental health conditions have greater difficulty managing diabetes. This study examined the association between mental health conditions and diabetes control, and medication adherence as a mediator in this relationship, among patients in a primary care setting affiliated with a large academic medical center.

Study Design: Data were drawn from questionnaires completed by patients in the waiting rooms of a primary care clinic and from patient electronic health records. Variables of interest were diagnosis of any mental health condition and diabetes control, as indicated by glycated hemoglobin (A1C) levels.

Methods: Logistic regression analyses were used to estimate the odds ratio (OR) and corresponding 95% CIs of controlled diabetes.

Results: Only 19% of patients had “good” diabetes control (A1C <6.5%). Surprisingly, better medication adherence and diagnosis of a mental health condition were significantly associated with good diabetes control, even after adjusting for known confounders in multivariable logistic regression analyses (OR, 2.4; 95% CI, 1.2-4.8).

Conclusions: These findings suggest that the identification of mental health problems among patients with diabetes is critical to improving patients’ diabetes control, particularly within settings that serve highly vulnerable patient populations.

The American Journal of Accountable Care. 2018;6(4):3-10

Become a Member to see the rest of this article and get access to all of our articles and resources. Membership is Free!

 
Copyright AJMC 2006-2018 Clinical Care Targeted Communications Group, LLC. All Rights Reserved.
x
Welcome the the new and improved AJMC.com, the premier managed market network. Tell us about yourself so that we can serve you better.
Sign Up
×

Sign In

Not a member? Sign up now!