title: Understanding preferences for type 2 diabetes mellitus self-management support through a patient-centered approach: a 2-phase mixed-methods study.
abstract: BACKGROUND
  Patients with type 2 diabetes mellitus (T2DM) who participate in diabetes management programs have been shown to have better glycemic control and slower disease progression, although program participation remains low. In the USA, increasing participation in diabetes management support programs may also directly impact provider reimbursement, as payments are increasingly based on patient-centered measures. However, little is known about factors that may enhance patient participation. This study aimed at further understanding what is important in diabetes management support from the patients' perspective and at assessing the utilization of various types of diabetes-management programs.
  
  
  METHODS
  A two-phase mixed-methods study was conducted of adult US members of PatientsLikeMe®, an online research network of patients. Phase 1 comprised qualitative interviews with 10 individuals to inform the online survey's contents, aided by literature review. During phase 2, this online survey was completed by 294 participants who reported on their diabetes goals and preferences for T2DM self-management support programs.
  
  
  RESULTS
  The majority of the respondents were not participating in any program (65 %), but most had goals of improving diet (77 %), weight loss (71 %), and achieving stable blood glucose levels (71 %). Among those currently participating in programs, clinic, hospital-based, or other health-care professional programs were the most commonly used (51 %). The most preferred type of support was diet/weight-loss support (62 %), while doctors or nurses (61 %) and dietitians (55 %) were the most preferred sources of diabetes support.
  
  
  CONCLUSIONS
  The low participation in diabetes self-management programs revealed in this study underscores the need for strategies to improve patient engagement. The results revealed support types and formats that patients with T2DM prefer and need. These findings may help improve patient engagement by guiding the future design of more effective diabetes management support programs.
authors.affiliation: Janssen Scientific Affairs, LLC, 1000 US Route 202 South, Raritan, NJ, 08869, USA. JMLopez@its.jnj.com.
authors.forename: Janice M S
authors.initials: JM
authors.lastname: Lopez
authors.affiliation: PatientsLikeMe Inc., 155 Second Street, Cambridge, MA, 02141, USA.
authors.forename: Bozena J
authors.initials: BJ
authors.lastname: Katic
authors.affiliation: PatientsLikeMe Inc., 155 Second Street, Cambridge, MA, 02141, USA.
authors.forename: Marcy
authors.initials: M
authors.lastname: Fitz-Randolph
authors.affiliation: Harvard Medical School, 50 Milk Street, 17th floor, Boston, MA, 02109, USA.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Jackson
authors.affiliation: Janssen Scientific Affairs, LLC, 1000 US Route 202 South, Raritan, NJ, 08869, USA.
authors.forename: Wing
authors.initials: W
authors.lastname: Chow
authors.affiliation: University of Maryland School of Pharmacy, Saratoga Building, 12th Floor, 220 Arch Street, Baltimore, MD, 21201, USA.
authors.forename: C Daniel
authors.initials: CD
authors.lastname: Mullins
mesh_terms: D000328:Adult; D001786:Blood Glucose; D015190:Blood Glucose Self-Monitoring; D003924:Diabetes Mellitus, Type 2 / Q000191:economics / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D044623:Nutrition Therapy; D010358:Patient Participation; D012648:Self Care / Q000523:psychology*; D012944:Social Support
chemical_list: D001786:Blood Glucose
keywords: Diabetes management support; Patient participation; Type 2 diabetes mellitus