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Primary Care Providers' Prediabetes Screening, Testing, and Referral Behaviors
Kunthea Nhim1, Tamkeen Khan2, Stephanie M Gruss1
1Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia.
American Journal of Preventive Medicine
|June 24, 2018
Summary
Primary care provider awareness of the National Diabetes Prevention Program lifestyle change program and the Prevent Diabetes STAT toolkit is linked to increased prediabetes screening and referrals. Enhancing provider knowledge can improve patient access to vital diabetes prevention interventions.
Area of Science:
- Public Health
- Preventive Medicine
- Health Services Research
Background:
- Intensive behavioral counseling effectively prevents type 2 diabetes, with growing insurance coverage for such programs.
- Referral rates to the Centers for Disease Control and Prevention (CDC)-recognized National Diabetes Prevention Program lifestyle change program are suboptimal, despite not requiring primary care provider referrals.
- The Prevent Diabetes STAT: Screen, Test, and Act Today™ toolkit aims to facilitate prediabetes management.
Purpose of the Study:
- To assess the association between primary care provider (PCP) behaviors (screening, testing, referral) for prediabetes and their awareness of the CDC-recognized lifestyle change program and the STAT toolkit.
- To identify practice characteristics influencing PCP engagement in prediabetes management and referral pathways.
Main Methods:
- A cross-sectional web-based survey (DocStyles 2016) of 1,256 primary care providers was analyzed.
- Multivariate logistic regression models were employed to evaluate the impact of PCP awareness and practice characteristics on prediabetes screening, testing, and referral behaviors, controlling for provider demographics.
Main Results:
- 38% of PCPs were aware of the CDC lifestyle change program, and 19% knew about the STAT toolkit.
- Awareness of both the lifestyle change program and STAT toolkit was positively associated with increased prediabetes screening and patient referrals.
- PCPs utilizing electronic health records demonstrated higher rates of screening, testing, and referral; referral rates were also higher in areas with more available lifestyle change program classes.
Conclusions:
- Increasing PCP awareness of the CDC-recognized lifestyle change program and the STAT toolkit is crucial for improving prediabetes screening and referral rates.
- Interventions aimed at enhancing provider knowledge and integrating digital health tools can bolster participation in diabetes prevention programs.
- Optimizing referral pathways and ensuring accessible lifestyle change program classes are essential for effective type 2 diabetes prevention in primary care settings.
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