Drass J, Kell S, Osborn M, Bausell B, Corcoran J, Moskowitz A, Fleming B
Center for Clinical Measurement and Improvement, Health Standards and Quality Bureau, Health Care Financing Administration, Baltimore, MD 21244-1850, USA.
Diabetes Care. 1998 Aug;21(8):1282-7. doi: 10.2337/diacare.21.8.1282.
To obtain information related to primary care physician (PCP) attitudes, knowledge, and practice patterns, as well as perceptions about barriers to care and the use of materials to assist in the delivery of diabetes care for elderly patients in the office setting.
A survey was mailed to a random sample (n = 900) of PCPs (internal medicine, family practice, and general practice physicians and endocrinologists) from the states of Alabama, Iowa, and Maryland who met selection criteria and provided diabetes care to > or = 25 Medicare beneficiaries during calendar year 1993.
Respondents provided self-reported information regarding diabetes care for elderly patients. PCP respondents (n = 370) considered blood glucose control to be the most important treatment goal. Most respondents (92%) considered acceptable GHb values to be those < 8%. Blood pressure measurement and foot inspections for the detection of ulcers and infection were the most commonly reported routine procedures performed as part of an office visit. Laboratory tests reported to be frequently ordered included GHb, serum creatinine, and proteinuria tests. Patient nonadherence to the treatment regimen was reported to be the most common barrier to care. The majority of respondents reported using two treatment aids in caring for patients with diabetes.
The results of this study provide some evidence that PCP self-reported attitudes, knowledge, and practice patterns in delivering diabetes care for elderly patients in the office setting more closely reflect current recommended practice than reported in previous physician surveys. Opportunities for improvement still exist.
获取与基层医疗医生（PCP）的态度、知识和实践模式相关的信息，以及他们对医疗护理障碍的看法，和在门诊环境中为老年患者提供糖尿病护理时辅助材料的使用情况。
向来自阿拉巴马州、爱荷华州和马里兰州的PCP（内科医生、家庭医生、全科医生和内分泌科医生）随机抽取的样本（n = 900）邮寄调查问卷，这些医生符合入选标准，且在1993日历年为≥25名医疗保险受益人提供糖尿病护理。
受访者提供了关于老年患者糖尿病护理的自我报告信息。PCP受访者（n = 370）认为血糖控制是最重要的治疗目标。大多数受访者（92%）认为可接受的糖化血红蛋白（GHb）值应<8%。作为门诊检查的一部分，血压测量和足部溃疡及感染检查是最常报告的常规程序。报告经常开具的实验室检查包括GHb、血清肌酐和蛋白尿检测。患者不遵守治疗方案被报告为最常见的护理障碍。大多数受访者报告在护理糖尿病患者时使用两种治疗辅助工具。
本研究结果提供了一些证据，表明PCP在门诊环境中为老年患者提供糖尿病护理时自我报告的态度、知识和实践模式比以往医生调查中报告的更能紧密反映当前推荐的做法。仍存在改进的机会。
