Jun Wu1, Eileen Ward2, Zhiqiang K Lu3. 1. Department of Pharmaceutical and Administrative Sciences, Presbyterian College School of Pharmacy, Clinton, SC, USA. jwu@presby.edu. 2. Department of Pharmacy Practice, Presbyterian College School of Pharmacy, Clinton, SC, USA. 3. Department of Clinical Pharmacy and Outcomes Sciences, University of South Carolina College of Pharmacy, Columbia, SC, USA.
Abstract
BACKGROUND: The gap between treatment guidelines and clinical practice in prediabetes management has been identified in previous studies. The knowledge related to addressing lifestyle change during office visits in clinical practice to manage prediabetes is limited. OBJECTIVE: To describe patterns of lifestyle management addressed during office-based visits involving patients with prediabetes and identify factors associated with addressing lifestyle management during physician office visits in the USA. DESIGN: Cross-sectional study PARTICIPANTS: US National Ambulatory Medical Care Survey (NAMCS) data from 2013 to 2015 were combined to identify office-based visits involving patients with prediabetes. MAIN MEASURES: The major outcome is lifestyle management including diet/nutrition, exercise, and/or weight reduction. Patient and physician characteristics were collected for analysis. The prevalence and patterns of addressing lifestyle management during visits were estimated and described. Multivariate logistic regression model identified significant factors associated with lifestyle management. The patient visit weight was applied to all analyses to achieve nationally representative estimates. KEY RESULTS: Among 4039 office-based visits involving patients with prediabetes between 2013 and 2015, 22.8% indicated lifestyle management was addressed during the visits. Diet/nutrition, exercise, and weight reduction accounted for 86.1%, 62.6%, and 34.1% of the visits with lifestyle management addressed, respectively. Lifestyle management was more likely to be addressed during the visits involving patients with hyperlipidemia (OR = 1.74, 95% CI 1.24-2.46) and obesity (OR = 4.03, 95% CI 2.91-5.56), seeing primary physicians (vs. other specialties, OR = 1.46, 95% CI 1.03-2.08), and living in the southern region (vs. northeast, OR = 1.96, 95% CI 1.20-3.19). CONCLUSIONS: The prevalence of addressing lifestyle management during office visits involving patients with prediabetes remained low in the USA. Patients' clinical characteristics, geographic region, and physician's specialty were associated with addressing lifestyle management during the visits.
BACKGROUND: The gap between treatment guidelines and clinical practice in prediabetes management has been identified in previous studies. The knowledge related to addressing lifestyle change during office visits in clinical practice to manage prediabetes is limited. OBJECTIVE: To describe patterns of lifestyle management addressed during office-based visits involving patients with prediabetes and identify factors associated with addressing lifestyle management during physician office visits in the USA. DESIGN: Cross-sectional study PARTICIPANTS: US National Ambulatory Medical Care Survey (NAMCS) data from 2013 to 2015 were combined to identify office-based visits involving patients with prediabetes. MAIN MEASURES: The major outcome is lifestyle management including diet/nutrition, exercise, and/or weight reduction. Patient and physician characteristics were collected for analysis. The prevalence and patterns of addressing lifestyle management during visits were estimated and described. Multivariate logistic regression model identified significant factors associated with lifestyle management. The patient visit weight was applied to all analyses to achieve nationally representative estimates. KEY RESULTS: Among 4039 office-based visits involving patients with prediabetes between 2013 and 2015, 22.8% indicated lifestyle management was addressed during the visits. Diet/nutrition, exercise, and weight reduction accounted for 86.1%, 62.6%, and 34.1% of the visits with lifestyle management addressed, respectively. Lifestyle management was more likely to be addressed during the visits involving patients with hyperlipidemia (OR = 1.74, 95% CI 1.24-2.46) and obesity (OR = 4.03, 95% CI 2.91-5.56), seeing primary physicians (vs. other specialties, OR = 1.46, 95% CI 1.03-2.08), and living in the southern region (vs. northeast, OR = 1.96, 95% CI 1.20-3.19). CONCLUSIONS: The prevalence of addressing lifestyle management during office visits involving patients with prediabetes remained low in the USA. Patients' clinical characteristics, geographic region, and physician's specialty were associated with addressing lifestyle management during the visits.
Authors: Aidin Rawshani; Araz Rawshani; Stefan Franzén; Björn Eliasson; Ann-Marie Svensson; Mervete Miftaraj; Darren K McGuire; Naveed Sattar; Annika Rosengren; Soffia Gudbjörnsdottir Journal: N Engl J Med Date: 2017-04-13 Impact factor: 91.245
Authors: Amy E Rothberg; Laura N McEwen; Andrew T Kraftson; Christine E Fowler; William H Herman Journal: J Diabetes Complications Date: 2014-03-29 Impact factor: 2.852
Authors: Anjali Gopalan; Ilona S Lorincz; Christopher Wirtalla; Steven C Marcus; Judith A Long Journal: Am J Prev Med Date: 2015-06-16 Impact factor: 5.043
Authors: Jaana Lindström; Pirjo Ilanne-Parikka; Markku Peltonen; Sirkka Aunola; Johan G Eriksson; Katri Hemiö; Helena Hämäläinen; Pirjo Härkönen; Sirkka Keinänen-Kiukaanniemi; Mauri Laakso; Anne Louheranta; Marjo Mannelin; Merja Paturi; Jouko Sundvall; Timo T Valle; Matti Uusitupa; Jaakko Tuomilehto Journal: Lancet Date: 2006-11-11 Impact factor: 79.321
Authors: Mark A Espeland; Henry A Glick; Alain Bertoni; Frederick L Brancati; George A Bray; Jeanne M Clark; Jeffrey M Curtis; Caitlin Egan; Mary Evans; John P Foreyt; Siran Ghazarian; Edward W Gregg; Helen P Hazuda; James O Hill; Don Hire; Edward S Horton; Van S Hubbard; John M Jakicic; Robert W Jeffery; Karen C Johnson; Steven E Kahn; Tina Killean; Abbas E Kitabchi; William C Knowler; Andrea Kriska; Cora E Lewis; Marsha Miller; Maria G Montez; Anne Murillo; David M Nathan; Ebenezer Nyenwe; Jennifer Patricio; Anne L Peters; Xavier Pi-Sunyer; Henry Pownall; J Bruce Redmon; Julia Rushing; Donna H Ryan; Monika Safford; Adam G Tsai; Thomas A Wadden; Rena R Wing; Susan Z Yanovski; Ping Zhang Journal: Diabetes Care Date: 2014-09 Impact factor: 19.112
Authors: Sidra L Speaker; Radhika Rastogi; Tamara A Sussman; Bo Hu; Anita D Misra-Hebert; Michael B Rothberg Journal: J Gen Intern Med Date: 2021-01-15 Impact factor: 5.128
Authors: Matthew J O'Brien; Maria C Vargas; Azucena Lopez; Yury Feliciano; Dyanna L Gregory; Paula Carcamo; Loretta Mohr; Nivedita Mohanty; Roxane Padilla; Ronald T Ackermann; Stephen D Persell; Joseph Feinglass Journal: Prev Med Rep Date: 2022-09-07