DIABETES CARE FOR MEDICARE BENEFICIARIES - ATTITUDES AND BEHAVIORS OFPRIMARY-CARE PHYSICIANS

OBJECTIVE - To obtain information related to primary care physician (P CP) attitudes, knowledge, and practice patterns, as well as perception s about barriers to care and the use of materials to assist in the del ivery of diabetes care for elderly patients in the office setting. RES EARCH DESIGN AND METHODS - A survey was mailed to a random sample (n = 900) of PCPs (internal medicine, family practice, and general practic e physicians and endocrinologists) from the states of Alabama, Iowa, a nd Maryland who met selection criteria and provided diabetes care to g reater than or equal to 25 Medicare beneficiaries during calendar year 1993. RESULTS - Respondents provided self-reported information regard ing diabetes care for elderly patients. PCP respondents (n = 370) cons idered blood glucose control to be the most important treatment goal. Most respondents (92%) considered acceptable GHb values to be those < 8%. Blood pressure measurement and foot inspections for the detection of ulcers and infection were the most commonly reported routine proced ures performed as part of an office visit. Laboratory tests reported t o be frequently ordered included GHb, serum creatinine, and proteinuri a tests. Patient nonadherence to the treatment regimen was reported to be the most common barrier to care. The majority of respondents repor ted using two treatment aids in caring for patients with diabetes. CON CLUSIONS - The results of this study provide some evidence that PCP se ll-reported attitudes, knowledge, and practice patterns in delivering diabetes care for elderly patients in the office setting more closely reflect current recommended practice than reported in previous physici an surveys. Opportunities for improvement still exist.