Adherence to clinical guidelines for monitoring diabetes in primary care settings  

作　　者：Mingliang Dai Michael RPeabody Lars EPeterson Arch GMainous III 

机构地区：[1]American Board of Family Medicine,1648 McGrathiana Parkway,Suite 550,Lexington,KY 40511,USA [2]University of Florida,Department of Health Services Research,Management and Policy,1225 Center Drive,HPNP 3107,Gainesville,FL 32611,USA [3]University of Florida,Department of Community Health and Family Medicine,1225 Center Drive,HPNP 3107,Gainesville,FL 32611,USA

出　　处：《Family Medicine and Community Health》2018年第4期161-167,共7页家庭医学与社区卫生（英文）

摘　　要：Objective:Adherence to clinical guidelines is key to improving diabetes care.Contemporary knowledge of guideline adherence is lacking.This study sought to produce a national snapshot of primary care physicians’(PCPs)adherence to the American Diabetes Association guidelines for monitoring diabetes and determine whether continuity of care promotes adherence.Methods:Using the 2013 National Ambulatory Medical Care Survey,we examined adher-ence to ordering hemoglobin A1c(HbA1c)and lipid profile tests as recommended by the American Diabetes Association for monitoring diabetes in 2379 primary care visits of patient with diabetes.Results:In the preceding 12 months,less than 60.0%of the patients were given a test rec-ommended for monitoring diabetes(58.0%for HbA1c and 57.0%for lipid profile).Continuity of care with PCPs increased the odds of adhering to diabetes monitoring guidelines by 36.0%for the HbA1c test(P=0.06)and by 76.0%for the lipid profile test(P=0.0006).Conclusion:A substantial gap exists in achieving optimal monitoring for diabetes in primary care settings in the United States.While PCPs are ideally positioned to ensure that guidelines are closely followed,we found that even in primary care settings,patient-provider continuity of care was associated with guideline adherence.

关 键 词：DIABETES guideline adherence primary care continuity of care 

分 类 号：R58[医药卫生—内分泌]