miércoles, 13 de enero de 2016

Initiation of treatment for incident diabetes: evidence from the electronic health records in an ambulatory care setting.

 2015 Feb;9(1):23-30. doi: 10.1016/j.pcd.2014.04.005. Epub 2014 May 5.

Initiation of treatment for incident diabetes: evidence from the electronic health records in an ambulatory care setting.

Abstract

OBJECTIVE:

We examined patterns and predictors of initiation of treatment for incident diabetes in an ambulatory care setting in the US.

METHODS:

Data were extracted from electronic health records (EHR) for active patients ≥ 35 years in a multispecialty, multiclinic ambulatory care organization with 1000 providers. New onset type 2 diabetes and subsequent treatment were identified using lab, diagnosis, medication prescription, and service use data. Time from the first evidence of diabetes until initial treatment, either medication or education/counseling, was examined using a Kaplan-Meier hazards curve. Potential predictors of initial treatment were examined using multinomial logistic models accounting for physician random effects.

RESULTS:

Of 2258 patients with incident diabetes, 55% received either medication or education/counseling (20% received both) during the first year. Of the treated patients, 68% received a treatment within the first four weeks, and 13% after initial 16 weeks. Strong positive predictors (P < 0.01) of combined treatment were younger age, higher fasting glucose at diagnosis, obesity, and visits with an endocrinologist.

CONCLUSIONS:

Among insured patients who have a primary care provider in a multispecialty health care system, incident diabetes is treated only half the time. Improved algorithms for identifying incident diabetes from the EHR and team approach for monitoring may help treatment initiation.
Copyright © 2014 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

KEYWORDS:

Ambulatory care; Diabetes treatment; Incident diabetes
PMID:
 
24810147
 
[PubMed - indexed for MEDLINE] 
PMCID:
 
PMC4221568
 [Available on 2016-02-01]

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