Primary care physicians play vital role in caring for diabetes patients

December 11, 2012

Previous research has shown that patients without a consistent primary care physician (PCP) have worse outcomes than those who do, but little is known about why this is true. New research from Brigham and Women's Hospital (BWH) has brought to light the importance of the role of a primary care physician in a population of diabetes patients. Their findings are published in the December 10, 2012 issue of Diabetes Care.

"We found that provide better care to when compared to other providers in a primary care setting because they were more likely to alter medications and consistently provide lifestyle counseling," said Alexander Turchin, MD, a physician and researcher in the Division of at BWH and the senior author of the paper.

Dr. Turchin and his research colleagues designed a study to evaluate whether PCP's provide higher to their patients by paying more attention to prescribed medications, offering lifestyle counseling more frequently or have a higher number of patient encounters when compared to other providers in a primary care setting including a covering physician or another provider such as a or physician assistant.

Researchers evaluated more than 27,000 patients with diabetes who were cared for in a primary care setting at two . Among these patients, there were nearly 585,000 primary care encounters over an average of five years and five months. Researchers report that 83 percent of those encounters were with a primary .

Additionally researchers report that covering physicians were the next most likely provider to see a patient, accounting for 13 percent of interactions, and they were also more likely to see a patient for an acute issue defined as a complaint of pain or infection.

Across all patient encounters, medication intensification, defined as either adding a new medication or increasing the dose of an existing medication, happened approximately 10 percent of the time and lifestyle counseling, as measured by documentation in the electronic health record, happened 40 percent of the time. The overall mean time between encounters was 1.6 months.

However, the odds of medication intensification were 49 and 26 percent higher respectively when a patient had an encounter with a PCP compared with a covering physician or mid-level provider. Additionally, the odds that lifestyle counseling occurred were 91 and 21 percent higher during an encounter with the PCP compared to a covering physician or another provider.

"Access to care is important and covering physicians and other providers play an important role in increasing access, especially in patients with acute complaints. With growing focus on a team based approach to practicing medicine, this finding should help guide the development of new models of primary care, especially in the care of diabetes patients. Based on this finding, we would suggest better documentation and communication of the treatment plan through the electronic medical record to other care providers in efforts to help to bridge the gaps that we observed in this study," Dr. Turchin said.

Explore further: Lifestyle counseling reduces time to reach treatment goals for people with diabetes

Related Stories

Lifestyle counseling reduces time to reach treatment goals for people with diabetes

January 24, 2012
Lifestyle counseling, practiced as part of routine care for people with diabetes, helps people more quickly lower blood glucose, blood pressure and cholesterol levels and keep them under control, according to a large, long-term ...

Lifestyle counseling and glycemic control in patients with diabetes: True to form?

May 24, 2011
Electronic medical records (EMRs) have been in use for more than 30 years, but have only increased in utilization in recent years, due in part to research supporting the benefits of EMRs and federal legislation. As EMRs have ...

More frequent office visits associated with improvements in risk factors for patients with diabetes

September 26, 2011
Visiting a primary care clinician every two weeks was associated with greater control of blood glucose, blood pressure and cholesterol levels among patients with diabetes, according to a report in the September 26 issue of ...

Primary care-based weight intervention helps obese patients reduce weight

November 14, 2011
Can a visit to your primary care doctor help you lose weight? Primary care physicians, working with medical assistants in their practices, helped one group of their obese patients lose an average of 10.1 lb during a two-year ...

Referral decisions differ between primary care physicians and specialists

September 19, 2011
How do physicians decide which colleague to refer their patient to? It differs depending on whether you ask primary care or specialist physicians, according to research from Harvard Medical School, Brigham and Women's Hospital, ...

Recommended for you

Alzheimer's drug cuts hallmark inflammation related to metabolic syndrome by 25 percent

July 20, 2017
An existing Alzheimer's medication slashes inflammation and insulin resistance in patients with metabolic syndrome, a potential therapeutic intervention for a highly dangerous condition affecting 30 percent of adults in the ...

Diabetes or its precursor affects 100 million Americans

July 19, 2017
Almost one-third of the US population—100 million people—either has diabetes or its precursor condition, known as pre-diabetes, said a government report Tuesday.

One virus may protect against type 1 diabetes, others may increase risk

July 11, 2017
Doctors can't predict who will develop type 1 diabetes, a chronic autoimmune disease in which the immune system destroys the cells needed to control blood-sugar levels, requiring daily insulin injections and continual monitoring.

Diabetes complications are a risk factor for repeat hospitalizations, study shows

July 7, 2017
For patients with diabetes, one reason for hospitalization and unplanned hospital readmission is severe dysglycemia (uncontrolled hyperglycemia - high blood sugar, or hypoglycemia - low blood sugar), says new research published ...

Researchers identify promising target to protect bone in patients with diabetes

July 7, 2017
Utilizing metabolomics research techniques, NYU Dentistry researchers investigated the underlying biochemical activity and signaling within the bone marrow of hyperglycemic mice with hopes of reducing fracture risks of diabetics

Immune system killer cells increase risk of diabetes

July 6, 2017
More than half of the German population is obese. One effect of obesity is to chronically activate the immune system, placing it under continuous stress. Researchers in Jens Brüning's team at the Max-Planck-Institute for ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.