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Updated: Aug 29, 2026

A Point-of-Care Method with Integrated Decision Support Tool to Estimate Anemia at Population Level
Published on: January 19, 2024
Clinical decisions regarding HbA1c results in primary care: a report from CaReNet and HPRN
Bennett L Parnes1, Deborah S Main, L Miriam Dickinson
1Department of Family Medicine, Division of Geriatrics, University of Colorado Health Sciences Center, Aurora, Colorado 80010, USA. bennett.parnes@uchsc.edu
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.
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