title: Patient-Centered Care, Glycemic Control, Diabetes Self-Care, and Quality of Life in Adults with Type 2 Diabetes.
abstract: The Affordable Care Act places a newfound emphasis on patient-centered medical home and patient-centered care (PCC). The purpose of this study was to evaluate the relationship between PCC, diabetes self-care, glycemic control, and quality of life (QOL) in a sample of adults with type 2 diabetes.
  
  
  
  Six hundred fifteen patients were recruited from two adult primary care clinics in the southeastern United States. Primary outcome variables were self-care behaviors (medication adherence, diet, exercise, blood sugar testing, and foot care), glycemic control, and QOL (physical component summary [PCS] score and mental component summary [MCS] score of SF12). PCC was assessed using a modified 7-item Picker Patient Experience Questionnaire. Regression modeling was used to assess independent associations while adjusting for relevant covariates.
  
  
  
  In adjusted analyses, PCC was significantly associated with PCS QOL (β = -0.03, 95% confidence interval [CI] -0.05 to -0.01), MCS QOL (β = 0.09, 95% CI 0.04-0.14), medication adherence (β = 0.12, 95% CI 0.08-0.17), general diet (β = 0.12, 95% CI 0.07-0.17), specific diet (β = 0.05, 95% CI 0.01-0.08), blood sugar testing (β = 0.09, 95% CI 0.04-0.15), and foot care (β = 0.12, 95% CI 0.07-0.18).
  
  
  
  PCC is associated with diabetes self-management and QOL, but was not significantly associated with glycemic control in patients with diabetes. PCC may be an important factor in self-care behaviors, but the process of focusing care around the patient may need to expand throughout the healthcare system before changes in outcomes such as glycemic control are noted.
authors.affiliation: 1 Department of Medicine, Center for Health Disparities Research, Medical University of South Carolina , Charleston, South Carolina.|2 Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina , Charleston, South Carolina.
authors.forename: Joni S
authors.initials: JS
authors.lastname: Williams
authors.affiliation: 1 Department of Medicine, Center for Health Disparities Research, Medical University of South Carolina , Charleston, South Carolina.|2 Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina , Charleston, South Carolina.|3 Health Equity and Rural Outreach Innovation Center (HEROIC), Ralph H. Johnson Department of Veterans Affairs Medical Center , Charleston, South Carolina.
authors.forename: Rebekah J
authors.initials: RJ
authors.lastname: Walker
authors.affiliation: 4 Center for Surgery and Public Health , Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Brittany L
authors.initials: BL
authors.lastname: Smalls
authors.affiliation: 1 Department of Medicine, Center for Health Disparities Research, Medical University of South Carolina , Charleston, South Carolina.|2 Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina , Charleston, South Carolina.
authors.forename: Rachel
authors.initials: R
authors.lastname: Hill
authors.affiliation: 1 Department of Medicine, Center for Health Disparities Research, Medical University of South Carolina , Charleston, South Carolina.|2 Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina , Charleston, South Carolina.|3 Health Equity and Rural Outreach Innovation Center (HEROIC), Ralph H. Johnson Department of Veterans Affairs Medical Center , Charleston, South Carolina.
authors.forename: Leonard E
authors.initials: LE
authors.lastname: Egede
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy / Q000628:therapy*; D004032:Diet; D015444:Exercise; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D058991:Patient Protection and Affordable Care Act; D018802:Patient-Centered Care; D011788:Quality of Life; D012648:Self Care
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin