Factors influencing diabetes treatment satisfaction in the INtegrating DEPrEssioN and Diabetes treatmENT randomized clinical trial: A multilevel model analysis
Authors' conclusion
Increased burden of depressive symptoms influences diabetes care satisfaction. Clinic-level predictors also significantly influence diabetes care satisfaction and can reduce dissatisfaction in primary care, specifically, reminder calls from clinic staff.
Study context
- Population
- Participants of the INtegrating DEPrEssioN and Diabetes treatmENT trial; patient-level (treatment assignment, depression severity, systolic BP, BMI, LDL-C, HbA1c) and clinic-level predictors (visit frequency, visit cost, number of specialists, wait time, time with provider, verbal reminders)
- Primary endpoint
- Change in diabetes care satisfaction
- Follow-up
- 0 to 24 months
Methodological detailsmultilevel model analysis, fixed and random effects models, longitudinal
- Multilevel model analysis
- Fixed and random effects models
- Longitudinal
Primary result
As reported in the abstract
Predictors of change in diabetes care satisfaction
- Model 1 (patient-level predictors): change in diabetes satisfaction accounted for
- 7%
- Model 1: change in depressive symptoms vs care satisfaction (negative relationship)
- β = −0.23, SE = 0.12, p < 0.05
- Model 1: variance explained by clinic-level predictors
- 2%
- Model 2 (patient- and clinic-level predictors): change in diabetes care satisfaction accounted for
- 18%
- Model 2: variance attributed to clinic-level predictors
- 9%
Further findings
Cross-level interaction: effect of change in depression on change in satisfaction by verbal reminder
- Received verbal reminder
- β = −0.11, SE = 0.21, p = 0.34
- No reminder
- β = −0.62, SE = 0.08, p < 0.01
- Change in depression had less impact on satisfaction with a verbal reminder
Original publication
Factors influencing diabetes treatment satisfaction in the INtegrating DEPrEssioN and Diabetes treatmENT randomized clinical trial: A multilevel model analysis. Diabet Med. Published 22 July 2024. doi:10.
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