3187.0: Monday, November 13, 2000 - Board 4

Abstract #8608

Physician's perceptions about the American Diabetes Association Standards of Care and barriers to implementation

Elizabeth Humphrey Paul, EdD, MPH, CHES and Charles E. Basch, PhD. Department of Health and Behavior Studies, Columbia University Teachers College, 127 West 92nd Street, Apt 4a, New York, NY 10025, 212 749-2340, ehp2@columbia.edu

Context: Sub-optimal monitoring and treatment of Diabetes Mellitus can increase the risk of serious long-term complications. Primary care physicians play a central role in the management of diabetes. Objective: To improve understanding about the obstacles to implementation of the American Diabetes Association Standards of Care in the routine management of individuals with diabetes. Methods: A random sample of 800 primary care physicians was selected from an independent practice managed care organization in the northeastern United States. Physicians' opinions regarding the importance and feasibility of the Standards of Care for diabetes and barriers to adherence were evaluated in a cross-sectional study. Results: All standards were generally perceived as important and feasible, but eye and foot exams and lipid tests were rated highest. Physicians graduating from medical school more recently rated the standards as more important and feasible than those graduating earlier. Ratings varied across states. Physicians reported that reimbursement, patient compliance and lack of time were barriers to adherence. To date, this is one of the largest surveys of independently practicing primary care physicians. A 57 % response rate was achieved. Conclusions: Physicians broadly support the Standards of Care for diabetes citing patient compliance as the greatest barrier to implementation. Understanding physician perceptions is paramount to the development of programs and policies that increase compliance with Standards of Care in clinical practice.

Learning Objectives: At the conclusion of the session, the participant (learner) will be able to: Understand the issues facing physicians in a managed care environment List barriers to diabetes care Discuss ways in which the results may apply to diabetes care in other physician practice settings Discuss how the study's methods could be used to evaluate outpatient care for other chronic conditions

Keywords: Diabetes, Physicians

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA