An Unsafe/Safe Typology in People with Type 2 Diabetes: Bridging Patients' Expectations, Personality Traits, Medication Adherence, and Clinical Outcomes

• Published in: Patient preference and adherence Vol. 16; pp. 1333 - 1350
• Main Authors: Reach, Gérard, Benarbia, Laurent, Benhamou, Pierre-Yves, Delemer, Brigitte, Dubois, Séverine, Gouet, Didier, Guerci, Bruno, Jeandidier, Nathalie, Lachgar, Karim, Le Pape, Gilles, Leroy, Rémy, Masgnaux, Jean-Hugues, Raclet, Philippe, Reznik, Yves, Riveline, Jean-Pierre, Schaepelynck, Pauline, Vambergue, Anne, Vergès, Bruno
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 31.05.2022; Dovepress; Dove; Dove Medical Press
• Subjects: adherence; Care and treatment; clinical outcomes; Diabetics; Health aspects; Life Sciences; Original Research; Patient compliance; patients’ expectations; Personality; personality traits; Psychological aspects; Social networks; support programs; Surveys; Type 2 diabetes; typology; France; patients’ expectations; support programs; typology; clinical outcomes; type 2 diabetes; adherence; personality traits
• ISSN: 1177-889X; 1177-889X
• DOI: 10.2147/PPA.S365398

Support programs are provided to people with diabetes to help them manage their disease. However, adherence to and persistence in support programs are often low, making it difficult to demonstrate their effectiveness. To identify the determinants of patients' perceived interest in diabetes support programs because it may be a powerful determinant of effective participation in such programs. An online study conducted in April 2021 in metropolitan France on 600 people with diabetes recruited from a consumer panel. A 64-item psychosocial questionnaire including a question asking to evaluate the helpfulness of a support program was used. Univariate, multivariate, and multiple correspondence analyses were performed. The existence of a typology, known as , was discovered, in which patients with type 2 diabetes respond in two distinct ways. Type (unsafe) patients, who believe that a support program would be helpful, are more likely to be nonadherent to their treatment, have high hemoglobin A1c levels, have at least one diabetic complication, lack information regarding their disease and treatment, rate the burden of their disease and impairment of their quality of life as high, worry about their future, and are pessimistic. Type (safe) patients have the opposite characteristics. Type patients can be dichotomized into two broad classes: one in which they lack information regarding disease and treatment and the other in which alterations in the quality of life and burden of the disease predominate. Insulin-treated patients give more importance to the lack of information, whereas noninsulin-treated patients complain primarily about the burden of the disease and impairment of quality of life. This study describes this new typology, proposes a simple method based on a nine-item questionnaire to identify type patients by calculating a Program Helpfulness Score described herein, and clarifies the nature of the intervention to be provided to them. This novel approach could be applied to other chronic diseases.