Home > Publications . Search All . Browse All . Country . Browse PSC Pubs . PSC Report Series

PSC In The News

RSS Feed icon

Clinton's and Trump's appeal to voters viewed from perspective of Neidert and Lesthaeghe's SDT framework

Stephenson assessing in-home HIV testing and counseling for male couples

Thompson says mass incarceration causes collapse of Detroit neighborhoods

Highlights

Maggie Levenstein named director of ISR's Inter-university Consortium for Political and Social Research

Arline Geronimus receives 2016 Harold R. Johnson Diversity Service Award

PSC spring 2016 newsletter: Kristin Seefeldt, Brady West, newly funded projects, ISR Runs for Bob, and more

AAUP reports on faculty compensation by category, affiliation, and academic rank

Next Brown Bag

PSC Brown Bags
will resume fall 2016

Beyond comorbidity counts: How do comorbidity type and severity influence diabetes patients' treatment priorities and self-management?

Publication Abstract

Kerr, E.A., Michele Heisler, S.L. Krein, M. Kabeto, Kenneth M. Langa, David Weir, and J.D. Piette. 2007. "Beyond comorbidity counts: How do comorbidity type and severity influence diabetes patients' treatment priorities and self-management?" Journal of General Internal Medicine, 22(12): 1635-1640.

BACKGROUND The majority of older adults have 2 or more chronic conditions and among patients with diabetes, 40% have at least three. OBJECTIVE We sought to understand how the number, type, and severity of comorbidities influence diabetes patients' self-management and treatment priorities. DESIGN Cross-sectional observation study. PATIENTS A total of 1,901 diabetes patients who responded to the 2003 Health and Retirement Study (HRS) diabetes survey. MEASUREMENTS We constructed multivariate models to assess the association between presence of comorbidities and each of 2 self-reported outcomes, diabetes prioritization and self-management ability, controlling for patient demographics. Comorbidity was characterized first by a count of all comorbid conditions, then by the presence of specific comorbidity subtypes (microvascular, macrovascular, and non-diabetes related), and finally by severity of 1 serious comorbidity: heart failure (HF). RESULTS 40% of respondents had at least 1 microvascular comorbidity, 79% at least 1 macrovascular comorbidity, and 61% at least 1 non-diabetes-related comorbidity. Patients with a greater overall number of comorbidities placed lower priority on diabetes and had worse diabetes self-management ability scores. However, only macrovascular and non-diabetes-related comorbidities, but not microvascular comorbidities, were associated with lower diabetes prioritization, whereas higher numbers of microvascular, macrovascular, and non-diabetes-related conditions were all associated with lower diabetes self-management ability scores. Severe, but not mild, HF was associated with lower diabetes prioritization and self-management scores. CONCLUSIONS The type and severity of comorbid conditions, and not just the comorbidity count, influence diabetes patients' self-management. Patients with severely symptomatic comorbidities and those with conditions they consider to be unrelated to diabetes may need additional support in making decisions about care priorities and self-management activities.

DOI:10.1007/s11606-007-0313-2 (Full Text)

PMCID: PMC2219819. (Pub Med Central)

Browse | Search : All Pubs | Next