Prevalence and correlates of preventive care among adults with diabetes inKansas

OBJECTIVE - To assess the prevalence and correlates of recommended preventi ve care among adults with diabetes in Kansas. RESEARCH DESIGN AND METHODS - A cross-sectional telephone survey was conduc ted among a sample of adults (greater than or equal to 18 pars of age) with self-reported diabetes. Recommended preventive care was defined based an f our criteria: number of health-care provider (HCP) visits per pear (greater than or equal to 4 for insulin users and greater than or equal to 2 For no nusers), number of foot examinations per year (greater than or equal to 4 f or insulin users and greater than or equal to 2 for nonusers), an annual di lated eye examination, and a blood Pressure measurement in the past 6 month s. RESULTS - The mean age of the 640 respondents was 61 years, 58% were women, and 86% were white. In the preceding year, 62% of respondents reported the appropriate number of visits to a HCP, 27% the appropriate number of foot examinations, 65% an annual dilated eye examination, and 89% a blood pressu re measurement in the preceding 6 months. Only 17% (95% CI 14-20) met all f our criteria for recommended care. The adjusted odds of receiving recommend ed care were higher for males than for females (odds ratio [OR] 1.6, 95% CI 1.1-2.5), higher for people whose HCP scheduled follow-up appointments tha n for those who self-initiated follow-up (OR 2.7, 95% CI 1.6-4.8), and high er for former smokers than for current smokers (OR 3.1: 95% CI 1.6-6.9). CONCLUSIONS - Preventive care for people with diabetes is not being deliver ed in compliance with current guidelines, especially for women and current smokers. Scheduling follow-up visits for patients, targeting certain high-r isk populations, and developing protocols to improve foot care may be effec tive in improving care.