Appointment attendance predicts level of glycaemic control in people with diabetes

Barbara M Rohland MD (Commentry Author)
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引用次数: 1

Abstract

Question

Do people who miss scheduled healthcare appointments have poorer management of their diabetes?

Study design

Retrospective cross-sectional cohort study.

Main results

During the year 2000, 12% of participants missed >30% of scheduled appointments, 52% missed 1–30% and 35% missed none. Glycaemic control was poorer in those who missed most appointments (p<0.0001), irrespective of how diabetes was controlled (diet, oral agent or insulin). The adjusted mean glycosylated haemoglobin level (HbA1c) was higher in people attending appointments compared with people missing >30% of appointments (p<0.0001). Daily self-monitoring was associated with a fewer missed appointments (OR 1.8, 95% CI 1.7 to 1.9). People with inadequate medication ⩾20% of the time were more likely to miss appointments (OR 1.5, p<0.0001). Living in a poverty area, pharmacologic control of diabetes, use of antidepressants and having fewer scheduled appointments were significantly associated with missing >30% of scheduled appointments.

Authors’ conclusions

People with diabetes who frequently miss appointments are likely to have poorer glycaemic control and less frequent self-monitoring. Level of attendance could be monitored and used for clinical risk stratification.

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预约就诊可以预测糖尿病患者的血糖控制水平
问题错过预定医疗预约的人对糖尿病的管理是否较差?研究设计回顾性横断面队列研究。主要结果在2000年,12%的参与者错过了>;30%的预约,52%错过了1-30%,35%没有错过。无论如何控制糖尿病(饮食、口服药物或胰岛素),错过大多数预约的患者的血糖控制较差(p<0.0001)。与失踪的人相比,参加预约的人的调整后的平均糖化血红蛋白水平(HbA1c)更高>;30%的预约(p<;0.0001)。每日自我监测与较少的错过预约有关(OR 1.8,95%CI 1.7至1.9)。药物不足的人20%的时间更有可能错过预约(OR 1.5,p<;.0001)。生活在贫困地区,糖尿病的药物控制,抗抑郁药的使用和较少的预约与错过>;30%的预约。作者的结论:经常错过预约的糖尿病患者可能血糖控制较差,自我监测频率较低。可以监测就诊水平,并将其用于临床风险分层。
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