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The Journal of the American Board of Family Practice 18:262-270 (2005)
© 2005 American Board of Family Practice

How Much Time Do Patients with Diabetes Spend on Self-Care?

Monika M. Safford, MD, Louise Russell, PhD, Dong-Churl Suh, PhD, Sheila Roman, MD and Leonard Pogach, MD

University of Alabama at Birmingham Preventive Medicine (MMS)
Rutgers University (LR, D-CS)
Johns Hopkins University (SR)
Veterans Affairs New Jersey Healthcare System (LP)

Correspondence: Corresponding author: Monika M. Safford, MD, University of Alabama at Birmingham Preventive Medicine, 1717 11th Avenue South, MT643, Birmingham, AL 35294 (e-mail: msafford{at}uab.edu)

Introduction: Little is reported about how much time patients spend on self-management, a cornerstone of diabetes care.

Methods: We studied a cross-section of 1482 diabetic patients enrolled in 3 northeastern United States managed care plans. Patients were surveyed about how much time they spent on foot care, exercise, and food shopping/preparation (7/00 to 9/01). Logistic regressions modeled which types of patients were likely to spend time, and linear regressions modeled characteristics associated with spending more/less time.

Results: Patients (57.9% ≥55 years; 51.6% women; 36.2% African American; 31.1% on insulin) spent 58 (mean) minutes/day on self-care (interquartile range 19, 84). Many patients skipped individual self-care elements: 37.9% reported no foot care, 37.7% no exercise, and 54.4% no time on food shopping/preparation. One fourth of patients with severe foot neuropathy symptoms spent no time on foot care. Never self-testers were less likely than others to engage in foot care (odds ratio (OR) 0.4 (95% CI 0.3, 0.6), exercise (OR 0.4 (95% CI 0.3, 0.6)), and food shopping/preparation (OR 0.7 (95% CI 0.5, 1.0)), and were likely to spend 30 minutes less total self-care time than frequent self-testers (P <.01).

Discussion: Most people spent considerable time engaged in self-care, but many skipped individual tasks, offering clinicians opportunities for collaborative decision making.






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Copyright © 2005 by the American Board of Family Medicine.