FRI084 The Impact Of COVID-19 On Comorbid Beliefs And Adherence To Self-Management Behaviors Among Breast Cancer Survivors With Type 2 Diabetes
Authors: Lambert Sherene , Itty Jennifer E , Guerra Lauren , Goel Mita , Lin Jenny J , Harris Yael T 
Published: October 2023

Abstract
Disclosure: S. Lambert: None. J.E. Itty: None. L. Guerra: None. M. Goel: None. J.J. Lin: None. Y.T. Harris: None.
Introduction: During the first year of the Covid-19 pandemic, anxiety and depression rates increased substantially worldwide. Anxiety and depression can affect self-efficacy and health-related beliefs as well as diabetes self-management behaviors (DSMBs) such as diet, exercise, and medication adherence, which are crucial for glycemic control and preventing complications. Both Type 2 diabetes mellitus (T2DM) and breast cancer pose an increased risk of complications from Covid, which could exacerbate pandemic-related distress in patients with T2DM and a history of breast cancer. We compared diabetes beliefs and adherence to DSMBs in breast cancer survivors with T2DM, before Covid-19 versus during the first Covid-19 surge. Hypothesis: Patients will experience a change in diabetes beliefs and adherence to DSMBs in the setting of the Covid-19 pandemic. Methods: Eligible patients included women ≥ 55 years, diagnosed with Stage 0-IIIA breast cancer in the past 15 years, who had completed chemotherapy and/or were prescribed hormonal therapy, had pre-existing T2DM treated with ≥ 1 oral medication, and had been enrolled in an ongoing study of disease beliefs and cognition in breast cancer survivors with comorbid T2DM. We included patients with a baseline visit prior to Covid and a six-month follow up visit between March - September 2020. We assessed diabetes beliefs with the Illness Perception Questionnaire (IPQ) and DSMB adherence with the Summary of Diabetes Self Care Activities (SDSCA) questionnaire. Self-reported adherence to diabetes medication was assessed with the Medication Adherence Rating Scale (MARS). Signed rank tests were used to compare disease beliefs and DSMB adherence before versus during the first Covid-19 wave. Results: 26 patients completed baseline interviews prior to Covid and a six-month follow up visit during the first Covid-19 surge (mean age: 65 years; 27% White, 35% Black, 11% Asian/Pacific Islander, 27% unanswered). Diabetes beliefs did not differ significantly before versus during Covid (p &gt; 0.05 for all IPQ scales), nor did adherence to DSMBs including diet (days/week following a healthful eating plan: p = 0.87), exercise (days participating in a specific exercise: p = 0.40), and glucose monitoring (days checking blood sugar the number of times recommended: p = 0.84). No significant differences were seen in medication adherence (p = 0.698). Conclusion: In this small sample of breast cancer survivors with T2DM there appears to be no change in diabetes beliefs or DSMB adherence during the first Covid surge compared to baseline. These findings raise the possibility that individual patient factors play a greater role in adherence and disease beliefs than pandemic-related distress. Future analyses will expand the sample size and explore whether the extent to which the Covid-19 pandemic impacted patients moderates their disease beliefs and self-management.
Presentation: Friday, June 16, 2023