title: Correlates of family involvement before and during medical visits among older adults with high-risk diabetes.
abstract: To examine the characteristics of patients with diabetes who regularly receive help from a supporter in preparing for and attending medical visits, and the association between this help and clinical risk factors for diabetes complications.
  
  
  
  We linked survey data about family involvement for patients in the Veterans Health Administration system with poorly controlled Type 2 diabetes (n = 588; mean 67 years; 97% male) with health record data on blood pressure, glycaemic control and prescription-fill gaps. We used multivariable regression to assess whether supporter presence and, among patients with supporters, supporter role (visit preparation, accompaniment to medical visit or no involvement) were associated with concurrent trends in clinical risk factors over 2 years, adjusting for sociodemographic and health characteristics.
  
  
  
  Most patients (78%) had a main health supporter; of these, more had regular support for preparing for appointments (69%) than were regularly accompanied to them (45%). Patients with preparation help only were younger and more educated than accompanied patients. Support presence and type was not significantly associated with clinical risk factors.
  
  
  
  Family help preparing for appointments was common among these patients with high-risk diabetes. In its current form, family support for medical visits may not affect clinical factors in the short term. Supporters helping patients engage in medical visits may need training and assistance to have an impact on the clinical trajectory of patients with diabetes.
authors.affiliation: Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
authors.forename: M R
authors.initials: MR
authors.lastname: Janevic
authors.affiliation: Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA.|VA Ann Arbor Center for Clinical Management Research, Ann Arbor, MI, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Piette
authors.affiliation: VA Ann Arbor Center for Clinical Management Research, Ann Arbor, MI, USA.
authors.forename: D P
authors.initials: DP
authors.lastname: Ratz
authors.affiliation: Center for Statistical Consultation and Research, University of Michigan School of Public Health, Ann Arbor, MI, USA.
authors.forename: H M
authors.initials: HM
authors.lastname: Kim
authors.affiliation: VA Ann Arbor Center for Clinical Management Research, Ann Arbor, MI, USA.|Division of General Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
authors.forename: A-M
authors.initials: AM
authors.lastname: Rosland
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001071:Appointments and Schedules; D017028:Caregivers; D048909:Diabetes Complications / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D016014:Linear Models; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D015999:Multivariate Analysis; D000073222:Patient Health Questionnaire; D014481:United States; D014493:United States Department of Veterans Affairs
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human