Patient and practice factors associated with HbA1c testing frequency in patients with type 2 diabetes: a retrospective cohort study in Australian general practice
Chisato ‘Chrissy’ Imai
A * , Ling Li A , Rae-Anne Hardie A , Christopher Pearce A B and Andrew Georgiou A
A Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia.
B Aurora Primary Care Research Institute, Blackburn, Vic., Australia.
Australian Journal of Primary Health - https://doi.org/10.1071/PY22026
Submitted: 15 February 2022 Accepted: 17 February 2023 Published online: 16 March 2023
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Background: Better adherence to guideline-recommended glycated haemoglobin A1c (HbA1c) testing frequency is associated with better glycaemic control and lower risk of complications such as chronic kidney disease in patients with type 2 diabetes. This study investigates patient and practice factors associated with adherence to guideline-recommended HbA1c testing frequency.
Methods: A cohort of type 2 diabetes patients who regularly visited general practices from 2012 to 2018 was identified from 225 Australian general practices. With the goal of ≤53 mmol/mol, Australian guidelines recommend HbA1c testing at least 6-monthly. Patient history of HbA1c tests from 2017 to 2018 was used to define adherence to guidelines, and the associations with patient and practice factors were examined by regression models.
Results: Of the 6881 patients, 2186 patients (31.8%) had 6-monthly HbA1c testing. Patient age and anti-diabetic medications were associated with adherence to 6-monthly testing. When financial incentives are available to practices, a larger practice was associated with better adherence to 6-monthly testing.
Conclusions: The identified key factors such as age, practice size, medication, and incentive payments can be used to target initiatives aimed at improving guideline-recommended monitoring care for patients with type 2 diabetes to enhance their health outcomes.
Keywords: adherence, diabetes mellitus, disease management, glycated haemoglobin A1c, incentive, monitoring, practice guideline, practice size.
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