The role of concordant and discordant comorbidities on performance of self-care behaviors in adults with type 2 diabetes: a systematic review

Fekadu Aga,1 Sandra B Dunbar,2 Tedla Kebede,3 Rebecca A Gary21Department of Nursing, School of Nursing & Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 2Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA 30322, USA; 3Tikur Anbessa Sp...

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Autores principales:	Aga F, Dunbar SB, Kebede T, Gary RA
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	comorbidity concordant comorbidity diabetes self-care behaviors discordant comorbidity multimorbidity type 2 diabetes Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/26e88609ca1847d386b9ad5110b4625c
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spelling	oai:doaj.org-article:26e88609ca1847d386b9ad5110b4625c2021-12-02T09:03:12ZThe role of concordant and discordant comorbidities on performance of self-care behaviors in adults with type 2 diabetes: a systematic review1178-7007https://doaj.org/article/26e88609ca1847d386b9ad5110b4625c2019-03-01T00:00:00Zhttps://www.dovepress.com/the-role-of-concordant-and-discordant-comorbidities-on-performance-of--peer-reviewed-article-DMSOhttps://doaj.org/toc/1178-7007Fekadu Aga,1 Sandra B Dunbar,2 Tedla Kebede,3 Rebecca A Gary21Department of Nursing, School of Nursing & Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 2Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA 30322, USA; 3Tikur Anbessa Specialized Hospital, Diabetes & Endcrinology Unit, Department of Internal Medicine School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, EthiopiaBackground: Most patients with Type 2 diabetes (T2D) have high number of comorbid chronic conditions that can affect their self-care abilities. Guidelines for diabetes self-care behaviors are disease specific with little attention given to managing T2D with other comorbidities. Identifying comorbidities that either improve or potentially diminish the individual’s capacity to perform effective self-care behaviors is essential to enhance clinical outcomes. One such framework conceptualizes comorbidities as concordant or discordant with diabetes pathophysiological pathways and care goals.Objective: The purpose of this systematic review was to examine the role of diabetes-concordant and discordant chronic conditions on the performance of self-care behaviors in adults with T2D.Methods: A comprehensive literature search was undertaken to identify published English language articles through the following five electronic databases: PubMed, CINAHL, PsycINFO, ISI Web of Science, and EMBASE. Quantitative studies published from March 2006 to April 2018 were included. Quality of evidence was evaluated using the Joanna Briggs Institutes Critical Appraisal Tools (JBI-CAT) and rated using Quality Assessment Tool for Quantitative Studies (QATQS).Results: The initial database search identified 1,136 articles but only 33 studies that met the inclusion criteria were included. The most common concordant comorbidity was hypertension while depression was the most common discordant condition. Adherence to medications was the most frequent diabetes self-care behavior reported and tended to be higher among concordant comorbidities. The findings showed mixed results concerning the effect of some concordant comorbidities such as hypertension, hyperlipidemia, retinopathy, and heart failure on diabetes self-care behaviors. But, there is agreement across studies that diabetes-discordant comorbidities have a more detrimental effect on self-care behaviors.Conclusions: Concordant comorbidities may improve diabetes self-care, but the evidence is inconclusive. Future research using well designed studies are needed to examine the complex relationship between diabetes self-care and comorbidities.Keywords: comorbidity, concordant comorbidity, diabetes self-care behaviors, discordant comorbidity, multimorbidity, type 2 diabetesAga FDunbar SBKebede TGary RADove Medical Pressarticlecomorbidityconcordant comorbiditydiabetes self-care behaviorsdiscordant comorbiditymultimorbiditytype 2 diabetesSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol Volume 12, Pp 333-356 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	comorbidity concordant comorbidity diabetes self-care behaviors discordant comorbidity multimorbidity type 2 diabetes Specialties of internal medicine RC581-951
spellingShingle	comorbidity concordant comorbidity diabetes self-care behaviors discordant comorbidity multimorbidity type 2 diabetes Specialties of internal medicine RC581-951 Aga F Dunbar SB Kebede T Gary RA The role of concordant and discordant comorbidities on performance of self-care behaviors in adults with type 2 diabetes: a systematic review
description	Fekadu Aga,1 Sandra B Dunbar,2 Tedla Kebede,3 Rebecca A Gary21Department of Nursing, School of Nursing & Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 2Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA 30322, USA; 3Tikur Anbessa Specialized Hospital, Diabetes & Endcrinology Unit, Department of Internal Medicine School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, EthiopiaBackground: Most patients with Type 2 diabetes (T2D) have high number of comorbid chronic conditions that can affect their self-care abilities. Guidelines for diabetes self-care behaviors are disease specific with little attention given to managing T2D with other comorbidities. Identifying comorbidities that either improve or potentially diminish the individual’s capacity to perform effective self-care behaviors is essential to enhance clinical outcomes. One such framework conceptualizes comorbidities as concordant or discordant with diabetes pathophysiological pathways and care goals.Objective: The purpose of this systematic review was to examine the role of diabetes-concordant and discordant chronic conditions on the performance of self-care behaviors in adults with T2D.Methods: A comprehensive literature search was undertaken to identify published English language articles through the following five electronic databases: PubMed, CINAHL, PsycINFO, ISI Web of Science, and EMBASE. Quantitative studies published from March 2006 to April 2018 were included. Quality of evidence was evaluated using the Joanna Briggs Institutes Critical Appraisal Tools (JBI-CAT) and rated using Quality Assessment Tool for Quantitative Studies (QATQS).Results: The initial database search identified 1,136 articles but only 33 studies that met the inclusion criteria were included. The most common concordant comorbidity was hypertension while depression was the most common discordant condition. Adherence to medications was the most frequent diabetes self-care behavior reported and tended to be higher among concordant comorbidities. The findings showed mixed results concerning the effect of some concordant comorbidities such as hypertension, hyperlipidemia, retinopathy, and heart failure on diabetes self-care behaviors. But, there is agreement across studies that diabetes-discordant comorbidities have a more detrimental effect on self-care behaviors.Conclusions: Concordant comorbidities may improve diabetes self-care, but the evidence is inconclusive. Future research using well designed studies are needed to examine the complex relationship between diabetes self-care and comorbidities.Keywords: comorbidity, concordant comorbidity, diabetes self-care behaviors, discordant comorbidity, multimorbidity, type 2 diabetes
format	article
author	Aga F Dunbar SB Kebede T Gary RA
author_facet	Aga F Dunbar SB Kebede T Gary RA
author_sort	Aga F
title	The role of concordant and discordant comorbidities on performance of self-care behaviors in adults with type 2 diabetes: a systematic review
title_short	The role of concordant and discordant comorbidities on performance of self-care behaviors in adults with type 2 diabetes: a systematic review
title_full	The role of concordant and discordant comorbidities on performance of self-care behaviors in adults with type 2 diabetes: a systematic review
title_fullStr	The role of concordant and discordant comorbidities on performance of self-care behaviors in adults with type 2 diabetes: a systematic review
title_full_unstemmed	The role of concordant and discordant comorbidities on performance of self-care behaviors in adults with type 2 diabetes: a systematic review
title_sort	role of concordant and discordant comorbidities on performance of self-care behaviors in adults with type 2 diabetes: a systematic review
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/26e88609ca1847d386b9ad5110b4625c
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The role of concordant and discordant comorbidities on performance of self-care behaviors in adults with type 2 diabetes: a systematic review

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