Meeke Susan D, Weemer Megan M
A.T. Still University, 5850 E. Still Circle, Mesa, AZ 85206, USA; Novo Nordisk, Inc. 800 Scudders Mill Road, Plainsboro, NJ 08536, USA.
A.T. Still University, 5850 E. Still Circle, Mesa, AZ 85206, USA.
Prev Med Rep. 2024 Dec 12;49:102947. doi: 10.1016/j.pmedr.2024.102947. eCollection 2025 Jan.
As primary care physician numbers continue to decline, more patients with type 2 diabetes are likely to receive care from advanced practice providers (APPs), including physician assistants and nurse practitioners. Analyzing diabetes medication prescribing trends among these provider types is essential for ensuring evidence-based diabetes care. This retrospective, cross-sectional pilot study aimed to examine differences in type 2 diabetes medication prescribing trends by provider type (physicians vs. APPs) and geographic location, utilizing National Ambulatory Medical Care Survey (NAMCS) data.
Data from the NAMCS were collected in August 2022 for the years 2015, 2016, 2018 and analyzed using IBM SPSS, employing chi-square analysis to assess associations between provider type, geographic location, and prescribed medications. Frequency distributions were calculated for patient characteristics and provider types.
Patients prescribed at least one diabetes medication ( = 1444) were included. Most received care from physicians (93.7 %) in metropolitan areas (82.8 %). Statistically significant associations were found between provider type, geographical location, and medications prescribed. Nurse practitioners were more likely to prescribe newer diabetes medications, while physician assistants frequently prescribed basal insulin. Patients in non-metropolitan statistical areas were more often prescribed older medications, whereas those in the West were less likely to receive older medications.
The study revealed distinct prescribing patterns by provider type and geographic location. Notably, APPs tended to prescribe newer or specific medications in certain locations, highlighting the influence of provider type and geography on diabetes care. Further studies should include larger samples of APPs to deepen insights into these trends.
随着初级保健医生数量持续减少,越来越多的2型糖尿病患者可能会由高级执业提供者(APP)提供护理,包括医师助理和执业护士。分析这些提供者类型之间的糖尿病药物处方趋势对于确保循证糖尿病护理至关重要。这项回顾性横断面试点研究旨在利用国家门诊医疗护理调查(NAMCS)数据,研究按提供者类型(医生与APP)和地理位置划分的2型糖尿病药物处方趋势差异。
2022年8月收集了NAMCS中2015年、2016年、2018年的数据,并使用IBM SPSS进行分析,采用卡方分析评估提供者类型、地理位置和处方药物之间的关联。计算了患者特征和提供者类型的频率分布。
纳入了至少开具一种糖尿病药物的患者(n = 1444)。大多数患者在大都市地区(82.8%)接受医生的护理(93.7%)。在提供者类型、地理位置和处方药物之间发现了具有统计学意义的关联。执业护士更有可能开具较新的糖尿病药物,而医师助理经常开具基础胰岛素。非大都市统计区域的患者更常被开具较老的药物,而西部的患者接受较老药物的可能性较小。
该研究揭示了按提供者类型和地理位置划分的不同处方模式。值得注意的是,APP在某些地区倾向于开具较新的或特定的药物,突出了提供者类型和地理位置对糖尿病护理的影响。进一步的研究应纳入更大样本的APP,以加深对这些趋势的了解。