National Survey of Primary Care Physicians’ Knowledge, Practices, and Perceptions of Prediabetes

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Abstract

Background: Despite strong evidence and national policy supporting type 2 diabetes prevention, little is known about type 2 diabetes prevention in the primary care setting. Objective: Our objective was to assess primary care physicians’ knowledge and practice regarding perceived barriers and potential interventions to improving management of prediabetes. Design: Cross-sectional mailed survey. Participants: Nationally representative random sample of US primary care physicians (PCPs) identified from the American Medical Association Physician Masterfile. Main Measures: We assessed PCP knowledge, practice behaviors, and perceptions related to prediabetes. We performed chi-square and Fisher’s exact tests to evaluate the association between PCP characteristics and the main survey outcomes. Key Results: In total, 298 (33%) eligible participants returned the survey. PCPs had limited knowledge of risk factors for prediabetes screening, laboratory diagnostic criteria for prediabetes, and management recommendations for patients with prediabetes. Only 36% of PCPs refer patients to a diabetes prevention lifestyle change program as their initial management approach, while 43% discuss starting metformin for prediabetes. PCPs believed that barriers to type 2 diabetes prevention are both at the individual level (e.g., patients’ lack of motivation) and at the system level (e.g., lack of weight loss resources). PCPs reported that increased access to and insurance coverage of type 2 diabetes prevention programs and coordination of referral of patients to these resources would facilitate type 2 diabetes preventive efforts. Conclusions: Addressing gaps in PCP knowledge may improve the identification and management of people with prediabetes, but system-level changes are necessary to support type 2 diabetes prevention in the primary care setting.

Original languageEnglish (US)
JournalJournal of general internal medicine
DOIs
StateAccepted/In press - Jan 1 2019

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Prediabetic State
Primary Care Physicians
Type 2 Diabetes Mellitus
Primary Health Care
Surveys and Questionnaires
Insurance Coverage
Metformin
American Medical Association
Life Style
Motivation
Weight Loss
Referral and Consultation
Cross-Sectional Studies
Physicians

Keywords

  • prevention
  • primary care
  • survey research

ASJC Scopus subject areas

  • Internal Medicine

Cite this

@article{a3bbf30a03e84d7db9ec6ea236f6968a,
title = "National Survey of Primary Care Physicians’ Knowledge, Practices, and Perceptions of Prediabetes",
abstract = "Background: Despite strong evidence and national policy supporting type 2 diabetes prevention, little is known about type 2 diabetes prevention in the primary care setting. Objective: Our objective was to assess primary care physicians’ knowledge and practice regarding perceived barriers and potential interventions to improving management of prediabetes. Design: Cross-sectional mailed survey. Participants: Nationally representative random sample of US primary care physicians (PCPs) identified from the American Medical Association Physician Masterfile. Main Measures: We assessed PCP knowledge, practice behaviors, and perceptions related to prediabetes. We performed chi-square and Fisher’s exact tests to evaluate the association between PCP characteristics and the main survey outcomes. Key Results: In total, 298 (33{\%}) eligible participants returned the survey. PCPs had limited knowledge of risk factors for prediabetes screening, laboratory diagnostic criteria for prediabetes, and management recommendations for patients with prediabetes. Only 36{\%} of PCPs refer patients to a diabetes prevention lifestyle change program as their initial management approach, while 43{\%} discuss starting metformin for prediabetes. PCPs believed that barriers to type 2 diabetes prevention are both at the individual level (e.g., patients’ lack of motivation) and at the system level (e.g., lack of weight loss resources). PCPs reported that increased access to and insurance coverage of type 2 diabetes prevention programs and coordination of referral of patients to these resources would facilitate type 2 diabetes preventive efforts. Conclusions: Addressing gaps in PCP knowledge may improve the identification and management of people with prediabetes, but system-level changes are necessary to support type 2 diabetes prevention in the primary care setting.",
keywords = "prevention, primary care, survey research",
author = "Eva Tseng and Greer, {Raquel C.} and Paul O’Rourke and Yeh, {Hsin Chieh} and McGuire, {Maura M.} and Albright, {Ann L.} and Marsteller, {Jill A.} and Clark, {Jeanne M.} and Maruthur, {Nisa M.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s11606-019-05245-7",
language = "English (US)",
journal = "Journal of General Internal Medicine",
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T1 - National Survey of Primary Care Physicians’ Knowledge, Practices, and Perceptions of Prediabetes

AU - Tseng, Eva

AU - Greer, Raquel C.

AU - O’Rourke, Paul

AU - Yeh, Hsin Chieh

AU - McGuire, Maura M.

AU - Albright, Ann L.

AU - Marsteller, Jill A.

AU - Clark, Jeanne M.

AU - Maruthur, Nisa M.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Despite strong evidence and national policy supporting type 2 diabetes prevention, little is known about type 2 diabetes prevention in the primary care setting. Objective: Our objective was to assess primary care physicians’ knowledge and practice regarding perceived barriers and potential interventions to improving management of prediabetes. Design: Cross-sectional mailed survey. Participants: Nationally representative random sample of US primary care physicians (PCPs) identified from the American Medical Association Physician Masterfile. Main Measures: We assessed PCP knowledge, practice behaviors, and perceptions related to prediabetes. We performed chi-square and Fisher’s exact tests to evaluate the association between PCP characteristics and the main survey outcomes. Key Results: In total, 298 (33%) eligible participants returned the survey. PCPs had limited knowledge of risk factors for prediabetes screening, laboratory diagnostic criteria for prediabetes, and management recommendations for patients with prediabetes. Only 36% of PCPs refer patients to a diabetes prevention lifestyle change program as their initial management approach, while 43% discuss starting metformin for prediabetes. PCPs believed that barriers to type 2 diabetes prevention are both at the individual level (e.g., patients’ lack of motivation) and at the system level (e.g., lack of weight loss resources). PCPs reported that increased access to and insurance coverage of type 2 diabetes prevention programs and coordination of referral of patients to these resources would facilitate type 2 diabetes preventive efforts. Conclusions: Addressing gaps in PCP knowledge may improve the identification and management of people with prediabetes, but system-level changes are necessary to support type 2 diabetes prevention in the primary care setting.

AB - Background: Despite strong evidence and national policy supporting type 2 diabetes prevention, little is known about type 2 diabetes prevention in the primary care setting. Objective: Our objective was to assess primary care physicians’ knowledge and practice regarding perceived barriers and potential interventions to improving management of prediabetes. Design: Cross-sectional mailed survey. Participants: Nationally representative random sample of US primary care physicians (PCPs) identified from the American Medical Association Physician Masterfile. Main Measures: We assessed PCP knowledge, practice behaviors, and perceptions related to prediabetes. We performed chi-square and Fisher’s exact tests to evaluate the association between PCP characteristics and the main survey outcomes. Key Results: In total, 298 (33%) eligible participants returned the survey. PCPs had limited knowledge of risk factors for prediabetes screening, laboratory diagnostic criteria for prediabetes, and management recommendations for patients with prediabetes. Only 36% of PCPs refer patients to a diabetes prevention lifestyle change program as their initial management approach, while 43% discuss starting metformin for prediabetes. PCPs believed that barriers to type 2 diabetes prevention are both at the individual level (e.g., patients’ lack of motivation) and at the system level (e.g., lack of weight loss resources). PCPs reported that increased access to and insurance coverage of type 2 diabetes prevention programs and coordination of referral of patients to these resources would facilitate type 2 diabetes preventive efforts. Conclusions: Addressing gaps in PCP knowledge may improve the identification and management of people with prediabetes, but system-level changes are necessary to support type 2 diabetes prevention in the primary care setting.

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