Preventive care practices for diabetes management in two primary care samples

Purpose: To assess the level of physician performance on American Diabetes Association Provider Recognition Program (PRP) measures in two samples of primary care patients, as well as to identify patient, physician, and office characteristics related to performance levels. Methods: In the two studies, we surveyed 435 Type 2 diabetes patients, cared for by 47 different physicians, on their receipt of PRP preventive care activities. Results: Overall, patients in the two samples reported receiving 74% and 64% of recommended services. In both samples, performance of microvascular/glycemic control activities and cardiovascular lab checks (84% and 74%) was significantly higher than behavioral self-management/patient-focused activities (61% and 48%) (p<0.001). From a set of patient, physician, and practice setting characteristics, only the use of community resources for chronic illness management support was associated with service performance. Conclusions: We found considerable variability in the levels of performance in providing PRP-recommended activities. Greater attention should be focused on self-management and patient-focused activities, given that these are delivered less frequently than medical/laboratory checks. (C) 2000 American Journal of Preventive Medicine.