Suboptimal diabetes preventive care among Massachusetts emergency department patients: A missed opportunity

Abstract

The aim of this pilot study was to estimate patient adherence with diabetes preventive care measures among emergency department patients. A cross-sectional survey was conducted in five Massachusetts emergency departments. We enrolled consecutive diabetic adults over two 24-hour periods at each site and measured demographics, socioeconomic factors and adherence with recommended diabetes preventive care measures. We surveyed 713 patients (70% of those eligible) and enrolled the 109 patients having physician-diagnosed diabetes. Compared to Massachusetts surveillance data for the general population, emergency department diabetic patients were less likely to have: HbA1c measured within the past six months (54% vs 78%), attended a diabetes self-management class (35% vs 50%), examined their feet daily (53% vs 65%), and ever received the pneumococcal vaccine (46% vs 55%). PUbliG or no insurance, limited education and low income independently predicted the decreased likelihood of having HbA1c checked in the prior six months. We demonstrated that the emergency department may provide an important and novel opportunity to identify often disenfranchised patients with suboptimal diabetes preventive care. Copyright © 2007 John Wiley & Sons.