Primary Care

Primary care visits every 2 weeks linked to better treatment outcomes for patients with diabetes

Most patients with diabetes do not have their blood sugar, blood pressure (BP), or cholesterol under control. Although a variety of studies have shown that patients who visit their physicians more frequently have better outcomes, guidelines do not exist for how frequently patients with diabetes should be seen. A new study finds that people with diabetes who visit their primary care doctors every 2 weeks achieve targets for blood sugar, BP, and low-density lipoprotein-cholesterol (LDL-C) control the fastest. The Boston-based researchers retrospectively analyzed the relationship between provider encounter frequency and time to blood sugar, BP, and LDL-C control among 26,496 patients with diabetes and elevated hemoglobin A1c (indicating a high blood-sugar level), BP, and/or LDL-C treated by primary care physicians at two teaching hospitals between 2000 and 2009.
As the intervals between encounters lengthened (identified by notes in the electronic medical record), the proportion of patients who never reached treatment targets also rose steadily. A strong dose-response relationship between encounter frequency and patient outcomes was evident in all the associations analyzed by the researchers. They concluded that for many patients with elevated hemoglobin A1c, BP, or LDL-C, more frequent patient-provider encounters were associated with a shorter time to treatment target, and control was fastest at 2-week intervals. They suggest that visits every 2 weeks may be appropriate for the most severely uncontrolled patients. Their study was supported in part by the Agency for Healthcare Research and Quality (HS17050).
See "Encounter frequency and serum glucose level, blood pressure, and cholesterol level control in patients with diabetes mellitus," by Fritha Morrison, M.P.H., Maria Shubina, Sc.D., and Alexander Turchin, M.D., in the September 2011 Archives of Internal Medicine 171(17), pp. 1542-1550.