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Clinic Appointment Attendance in Adults with Serious Mental Illness and Diabetes

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Objectives: We assessed characteristics that may predict outpatient appointment attendance in outpatient medical clinics among patients comorbid for serious mental illness (SMI) and type 2 diabetes (DM). Methods: Baseline covariate data from 200 individuals with SMI-DM enrolled in a randomized controlled trial (RCT) were used to examine characteristics associated with electronic health record-identified clinic appointment attendance using a generalized estimating equations approach. The analyses evaluated the relationship between clinic attendance and potentially modifiable factors including disease knowledge, self-efficacy, social support, physical health, and mental health, as well as demographic information. Results: Demographic and mental health characteristics were most associated with clinic attendance in adults with SMI-DM. Physical health was not associated with clinic attendance. Conclusions: Information on clinical and demographic characteristics and factors potentially modifiable by psychological interventions may be useful in improving adherence to treatment among SMI-DM patients. It is our hope that clinicians and researchers will use these results to help tailor adherence-facilitating interventions among people at particular risk for poor engagement in care.
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Keywords: DIABETES; GENERALIZED ESTIMATING EQUATIONS; SERIOUS MENTAL ILLNESS; VISIT ADHERENCE

Document Type: Research Article

Affiliations: 1: Assistant Professor of Medicine and Population and Quantitative Health Sciences, Center for Health Care Research and Policy, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH;, Email: [email protected] 2: Senior Research Scientist, Eli Lilly and Company, Indianapolis, IN 3: Department of Quantitative Health Sciences, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH 4: Senior Scholar, Center for Health Care Research and Policy, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH 5: Professor of Medicine, Population and Quantitative Health Sciences, Center for Health Care Research and Policy, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH 6: Center for Health Care Research and Policy, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH 7: Department of Psychiatry, Case Western Reserve University School of Medicine, University Hospitals Case Medical Center, Cleveland, OH 8: Center for Health Care Research and Policy, MetroHealth Medical Center, Cleveland, OH 9: Professor of Medicine, Population and Quantitative Health Sciences, Case Western Reserve University and Center for Health Care Research and Policy, MetroHealth Medical Center, Cleveland, OH 10: Professor of Psychiatry, Neurology and Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine and Neurological Institute, University Hospitals Case Medical Center, Cleveland, OH

Publication date: November 1, 2017

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  • The American Journal of Health Behavior seeks to improve the quality of life through multidisciplinary health efforts in fostering a better understanding of the multidimensional nature of both individuals and social systems as they relate to health behaviors.

    The Journal aims to provide a comprehensive understanding of the impact of personal attributes, personality characteristics, behavior patterns, social structure, and processes on health maintenance, health restoration, and health improvement; to disseminate knowledge of holistic, multidisciplinary approaches to designing and implementing effective health programs; and to showcase health behavior analysis skills that have been proven to affect health improvement and recovery.

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