Preventive care practices for diabetes management in two primary care samples

Purpose: To assess the level of physician performance on American Diabetes Association Provider Recognition Program (PRP) measures in two samples of p rimary care patients, as well as to identify patient, physician, and office characteristics related to performance levels. Methods: In the two studies, we surveyed 435 Type 2 diabetes patients, care d for by 47 different physicians, on their receipt of PRP preventive care a ctivities. Results: Overall, patients in the two samples reported receiving 74% and 64 % of recommended services. In both samples, performance of microvascular/gl ycemic control activities and cardiovascular lab checks (84% and 74%) was s ignificantly higher than behavioral self-management/patient-focused activit ies (61% and 48%) (p<0.001). From a set of patient, physician, and practice setting characteristics, only the use of community resources for chronic i llness management support was associated with service performance. Conclusions: We found considerable variability in the levels of performance in providing PRP-recommended activities. Greater attention should be focus ed on self-management and patient-focused activities, given that these are delivered less frequently than medical/laboratory checks. (C) 2000 American Journal of Preventive Medicine.