Diabetes guidelines not often implemented in practice

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LAS VEGAS – Despite the existence of clinical practice guidelines to assist and direct diabetes care, relatively few clinicians actually use them in everyday practice, research presented in a poster session at the American Academy of Physician Assistants' 39th Annual PA Meeting suggests.

Kevin Schuer, MSPAS, MPH, PA-C, an assistant professor of physician assistant studies at the University of Kentucky in Lexington, and colleagues conducted a Web-based survey to determine attitudes, practice and motivating factors that influence guideline-based care delivery among 15 primary care providers in an ambulatory internal medicine group at the university.

Results from the 11 respondents that completed the survey indicated that clinicians generally agreed with diabetes clinical practice guidelines, with 63.3% indicating that they "strongly agreed," 27.2% indicating that they "agreed" and 9% stating that they were "neutral."

Despite this finding, only one clinician agreed that he or she used diabetes guidelines 100% of the time while delivering care. Nine respondents agreed that they used the guidelines between 75% to 100% of the time, and one provider indicated that he or she referred to the guidelines less than 50% of the time.

Participants identified the following motivating factors for utilizing diabetes guidelines: duty, ensuring quality health care, practice efficiency and the threat of pay for performance pay scale.

“Future research is needed to more clearly identify factors that encourage and enhance clinical practice guideline usage among clinicians caring for the chronically ill,” the researchers wrote.

Schuer K, Richardson C. “Assessing primary care clinicians' attitudes, practice and motivating factors influencing guideline-based care in diabetes mellitus.” Presented at: American Academy of Physician Assistants' 39th Annual PA Meeting. 2011; Las Vegas, Nevada.

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