Determinants of hospitalization in Chinese patients with type 2 diabetes receiving a peer support intervention and JADE integrated care: the PEARL randomised controlled trial
Publication in refereed journal

替代計量分析
.

其它資訊
摘要Background:
In a randomized controlled trial of 628 Chinese patients with type 2 diabetes receiving multidisciplinary care in the Joint Asia Diabetes Evaluation (JADE) Progam, 372 were randomized to receive additional telephone-based peer support (Peer Empowerment And Remote communication Linked by information technology, PEARL) intervention.
After 12 months, all-cause hospitalization was reduced by half in the PEARL group especially in those with high
Depression Anxiety and Stress Scale (DASS) scores.

Methods:
We used stratified analyses, negative binomial regression, and structural equation modelling (SEM) to examine
the inter-relationships between emotions, self-management, cardiometabolic risk factors, and hospitalization.

Results:
Hospitalized patients were older, more likely to have heart or kidney disease, and negative emotions than those without hospitalization. Patients with high DASS score who did not receive peer support had the highest hospitalization rates. After adjustment for confounders, peer support reduced the frequency of hospitalizations by
48% with a relative risk of 0.52 (95% CI 0·35–0·79;p = 0·0018). Using SEM, improvement of negative emotions
reduced treatment nonadherence (Est = 0.240, p = 0.034) and hospitalizations (Est=−0.218, p = 0.001). The latter
was also reduced by an interactive term of peer support and chronic kidney disease (Est = 0.833, p = < 0.001) and
that of peer support and heart disease (Est = 0.455, p = 0.001).

Conclusions:
In type 2 diabetes, improvement of negative emotions and peer support reduced hospitalizations, especially in those with comorbidities, in part mediated through improving treatment nonadherence. Integrating peer support is feasible and adds value to multidisciplinary care, augmented by information technology, especially in patients with comorbidities.

Trial registration: NCT00950716 Registered July 31, 2009.
出版社接受日期20.02.2018
著者Yeung RO, Cai JH, Zhang Y, Luk AO, Pan JH, Yin J, Ozaki R, Kong APS, Ma R, So WY, Tsang CC, Lau KP, Fisher E, Goggins W, Oldenburg B, Chan J
期刊名稱Clinical Diabetes and Endocrinology
出版年份2018
卷號4
期次5
頁次1 - 11
國際標準期刊號2055-8260
語言英式英語
關鍵詞Structural equation modelling, Quality improvement, Peer support, Integrated care, Hospitalizations, Negative emotions, Adherence

上次更新時間 2020-19-10 於 01:59