1. Clinical decisions regarding HbA1c results in primary care: a report from CaReNet and HPRN.
- Author
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Parnes BL, Main DS, Dickinson LM, Niebauer L, Holcomb S, Westfall JM, Pace WD, Parnes, Bennett L, Main, Deborah S, Dickinson, L Miriam, Niebauer, Linda, Holcomb, Sherry, Westfall, John M, Pace, Wilson D, CaReNet, and HPRN
- Abstract
Objective: To describe decisions made by primary care providers on elevated HbA(1c) results and their reasons for not intensifying therapy.Research Design and Methods: In this cross-sectional study, a provider survey was administered in two practice-based research networks when HbA(1c) results were reviewed on all nonpregnant patients >18 years old with type 2 diabetes. Univariate and Mantel-Hantel analyses assessed associations between patient characteristics and clinical decisions.Results: A total of 483 surveys were completed by at least 88 providers at 19 clinics. Most patients were female (62.5%), mean age was 60 years, and 28.6% were Hispanic. The overall action rate on HbA(1c) results >/=7% (n = 294) was 70.7%. Patients who were black or had Medicare without medication insurance had lower rates of action on HbA(1c) >/=7 and >/=8%, respectively (P < 0.05). The most common reasons providers reported for inaction were "patient improving/doing well," "competing demands," and "hypoglycemic risk."Conclusions: Primary care providers generally adhere to national glycemic control guidelines, although there may be disparities in black patients and patients without medication insurance coverage. A variety of reasons were given when control was not intensified. [ABSTRACT FROM AUTHOR]- Published
- 2004
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