학술논문

Patterns of type 2 diabetes monitoring in rural towns: How does frequency of HbA1c and lipid testing compare with existing guidelines?
Document Type
Article
Source
Australian Journal of Rural Health. Dec2016, Vol. 24 Issue 6, p371-377. 7p. 1 Diagram, 5 Charts.
Subject
*AGE distribution
*ALGORITHMS
*CONFIDENCE intervals
*GLYCOSYLATED hemoglobin
*PATIENT aftercare
*LIPIDS
*TYPE 2 diabetes
*PATIENT monitoring
*PROBABILITY theory
*RESEARCH funding
*RURAL health
*LOGISTIC regression analysis
*SOCIOECONOMIC factors
*HEALTH & social status
*ODDS ratio
Language
ISSN
1038-5282
Abstract
Objective: To indicate levels of monitoring of type 2 diabetes in rural and regional Australia by examining patterns of glycated haemoglobin (HbA1c) and blood lipid testing. Design and Setting: Retrospective analysis of pathology services data from twenty regional and rural towns in eastern Australia over 24 months. Participants: Of 13 105 individuals who had either a single HbA1c result ≥7.0% (53 mmol mol-1); or two or more HbA1c tests within the study period. Main outcome measures: Frequency of testing of HbA1c and blood lipids (cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol and triglycerides) were compared with guideline recommendations. Results: About 58.3% of patients did not have the recommended 6-monthly HbA1c tests and 30.6% did not have annual lipid testing. For those who did not receive tests at the recommended interval, the mean between-test interval was 10.5 months (95% CI = 7.5-13.5) rather than 6 months for HbA1c testing; and 15.7 (95% CI = 13.3-18.1) months rather than annually for blood lipids. For those with at least one out-of-range test result, 77% of patients failed to receive a follow-up HbA1c test and 86.5% failed to receive a follow-up blood lipid test within the recommended 3 months. Patients less than 50 years of age, living in a more remote area and with poor diabetes control were less likely to have testing at the recommended intervals (P < 0.0001). Conclusions: Although poor diabetes testing is not limited to rural areas, more intensive diabetes monitoring is likely to be needed for patients living in nonmetropolitan areas, particularly for some subgroups. [ABSTRACT FROM AUTHOR]