title: Interplay among patient empowerment and clinical and person-centered outcomes in type 2 diabetes. The BENCH-D study.
abstract: OBJECTIVE
  We evaluated empowerment in T2DM and identified its correlates.
  
  
  METHODS
  A sample of individuals self-administered the Diabetes Empowerment Scale-Short Form (DES-SF) and other 9 validated instruments (person-centered outcomes). Correlates of DES-SF were identified through univariate and multivariate analyses. For person-centered outcomes, ORs express the likelihood of being in upper quartile of DES-SF (Q4) by 5 units of the scale.
  
  
  RESULTS
  Overall, 2390 individuals were involved. Individuals in Q4 were younger, more often males, had higher levels of school education, lower HbA1c levels and prevalence of complications as compared to individuals in the other quartiles. The likelihood of being in Q4 was directly associated with higher selfreported self-monitoring of blood glucose (SDSCA6-SMBG) (OR=1.09; 95% CI: 1.03-1.15), higher satisfaction with diabetes treatment (GSDT) (OR=1.15; 95% CI: 1.07-1.25), perceived quality of chronic illness care and patient support (PACIC-SF) (OR=1.23; 95% CI: 1.16-1.31), and better person-centered communication (HCC-SF) (OR=1.10; 95% CI: 1.01-1.19) and inversely associated with diabetes-related distress (PAID-5) (OR=0.95; 95% CI: 0.92-0.98). Adjusted DES-SF mean scores ranged between centers from 69.8 to 93.6 (intra-class correlation=0.10; p<0.0001).
  
  
  CONCLUSIONS
  Empowerment was associated with better glycemic control, psychosocial functioning and perceived access to person-centered chronic illness care. Practice of diabetes center plays a specific role.
  
  
  CONCLUSIONS
  DES-SF represents a process and outcome indicator in the practice of diabetes centers.
authors.affiliation: CORE-Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy; Laboratory of Clinical Epidemiology of Diabetes and Chronic Diseases, Fondazione Mario Negri Sud, S. Maria Imbaro (CH), Italy. Electronic address: rossi@coresearch.it.
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Rossi
authors.affiliation: CORE-Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy; Laboratory of Clinical Epidemiology of Diabetes and Chronic Diseases, Fondazione Mario Negri Sud, S. Maria Imbaro (CH), Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lucisano
authors.affiliation: Department of Medical Education, University of Michigan Medical School, Ann Arbor, MI, USA.
authors.forename: Martha
authors.initials: M
authors.lastname: Funnell
authors.affiliation: Laboratory of Clinical Epidemiology of Diabetes and Chronic Diseases, Fondazione Mario Negri Sud, S. Maria Imbaro (CH), Italy; S.S.D. Diabetologia, Niguarda Ca' Granda Hospital, Milan, Italy.
authors.forename: Basilio
authors.initials: B
authors.lastname: Pintaudi
authors.affiliation: NovoNordisk SpA, Rome, Rome, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Bulotta
authors.affiliation: Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Gentile
authors.affiliation: CORE-Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy; Laboratory of Clinical Epidemiology of Diabetes and Chronic Diseases, Fondazione Mario Negri Sud, S. Maria Imbaro (CH), Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Scardapane
authors.affiliation: NovoNordisk A/S, Bagsvaerd, Denmark.
authors.forename: Soren Eik
authors.initials: SE
authors.lastname: Skovlund
authors.affiliation: Diabetes Unit, Madonna del Soccorso Hospital, San Benedetto del Tronto, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Vespasiani
authors.affiliation: CORE-Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy; Laboratory of Clinical Epidemiology of Diabetes and Chronic Diseases, Fondazione Mario Negri Sud, S. Maria Imbaro (CH), Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Nicolucci
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D015190:Blood Glucose Self-Monitoring; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000523:psychology*; D011209:Power, Psychological; D012648:Self Care
chemical_list: D001786:Blood Glucose
keywords: Empowerment; Person-centered outcomes; Quality of care; Type 2 diabetes