Use of diabetes monitoring tests in primary care suboptimal
Mingliang Dai, Ph.D., from the American Board of Family Medicine in Lexington, Kentucky, and colleagues examined adherence to ordering hemoglobin A1c (HbA1c) and lipid profile tests as recommended by the American Diabetes Association using the 2013 National Ambulatory Medical Care Survey. Data were included for 2,379 primary care visits for patients with diabetes.
The researchers found that less than 60.0 percent of the patients were given a test recommended for monitoring diabetes (58.0 percent for HbA1c and 57.0 percent for lipid profile) in the preceding 12 months. With continuity of care with primary care physicians (PCPs), the odds of adhering to diabetes monitoring guidelines increased by 36.0 (P = 0.06) and 76.0 percent (P = 0.0006) for the HbA1c and lipid profile tests, respectively.
"Forty percent of primary care visits of patients with diabetes were missed opportunities where PCPs were not providing guideline-concordant monitoring tests, creating a substantial gap in the quality of care for diabetes in U.S. primary care settings," the authors write. "Our findings suggest that enhancing patient-provider continuity of care may be effective in promoting guideline adherence."
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