Table 3 Details on selected patient measures

 Activation

Survey

Patient Activation Measure (PAM-13)

X

X

X

 Activation in health encounters

Survey

Perceived Efficacy in Patient-Physician Interactions (PEPPI-5)

X

X

X

 Diabetes self-efficacy

Survey

Stanford Chronic Disease Self-Efficacy Scale [72]

X

X

 Diabetes distress

Survey

Problem Areas in Diabetes Scale [73]

X

X

 Diabetes self-management behavior (self-monitoring, healthful eating, physical activity)

Survey

Summary of Diabetes Self-Care Activities [74]

X

X

X

 Diabetes medication adherence

EMR × 12 months

Cumulative medication gaps < 20% [75]

X

X

 Smoking status

Survey

Items from the World Health Organization’s Global Adult Tobacco Survey [76]

X

X

X

 5-Year cardiac event risk

survey + physiologic and lab testing

United Kingdom Prospective Diabetes Study (UKPDS) 5 year cardiac risk score

X

X

 Glycemic control

Venous sample

HbA1c

X

X

 Blood pressure

Direct measure

Systolic blood pressure, mean arterial pressure

X

X

 Non-fasting lipid levels

Venous sample

Total cholesterol/HDL

X

X

 Patient-supporter relationship quality

Survey

Relationship Rating Form - Respect Subscale [77]

X

X

 Patient satisfaction with diabetes social support

Survey

Diabetes Care Profile -Support Subscale [78]

X

X

X

 Supporter use of autonomy-supportive communication

Survey

Important Other Climate Questionnaire [79]

X

X

 Time with diabetes

Survey

X

 Patient comorbidities

EMR × 12 months

Charlson Comorbidity Index [80]

X

 Health literacy

Survey

Brief Health Literacy Screen [81]

X

 Current PTSD symptoms

Survey

Primary Care PTSD Screen for DSM5 [82]

X

 Depression and anxiety

Survey

Patient Health Questionnaire-4 [83]

X

X