title: Characteristics of patients with diabetes who accept referrals for care management services.
abstract: BACKGROUND
  Patients with chronic conditions can improve their health through participation in self-care programs. However, awareness of and enrollment in these programs are generally low.
  
  
  OBJECTIVE
  We sought to identify factors influencing patients' receptiveness to a referral for programs and services supporting chronic disease management.
  
  
  METHODS
  We analyzed data from 541 high-risk diabetic patients who completed an assessment between 2010 and 2013 from a computer-based, nurse-led Navigator referral program within a large primary care clinic. We compared patients who accepted a referral to those who declined.
  
  
  RESULTS
  A total of 318 patients (75%) accepted 583 referrals, of which 52% were for self-care programs. Patients who accepted a referral had more primary care visits in the previous year, were more likely to be enrolled in another program, expressed more interest in using the phone and family or friends for support, and were more likely to report recent pain than those who declined a referral.
  
  
  CONCLUSIONS
  Understanding what factors influence patients' decisions to consider and participate in self-care programs has important implications for program design and development of strategies to connect patients to programs. This work informs outreach efforts to identify and engage patients who are likely to benefit from self-care activities.
authors.affiliation: Departments of Advertising and Public Relations and Media and Information, Michigan State University, East Lansing, MI, USA.
authors.forename: Bree
authors.initials: B
authors.lastname: Holtz
authors.affiliation: VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.
authors.forename: Ann M
authors.initials: AM
authors.lastname: Annis
authors.affiliation: Department of Ambulatory Care, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.
authors.forename: Wendy
authors.initials: W
authors.lastname: Morrish
authors.affiliation: VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Davis Burns
authors.affiliation: VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA; Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Krein
keywords: Nursing; diabetes/endocrinology; primary care
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