Prevalence and Associated Characteristics of Inadequate Care during Management of Type-2 Diabetes Mellitus in the United States

Prevalence and Associated Characteristics of Inadequate Care during Management of Type-2 Diabetes Mellitus in the United States Benjamin Lewing, MS, MA, PhD; Susan M. Abughosh, PhD1, Lincy S. Lal, PhD, PharmD; Ekere J. Essien, MD, DrPH; Shubhada Sansgiry, PhD, MS; Sujit S. Sansgiry, MS, PhD Abstract Aim:: Noncompliance to following evidence-based guidelines in managing type 2 diabetes mellitus (T2D) can be considered inadequate care and can result in increased risk of diabetes-related complications. This study aims to better understand inadequate T2D care by examining its prevalence and associated characteristics. Methods: A retrospective cohort analysis was conducted, using most recently available 2018 Medical Expenditure Panel Survey data. The American Diabetes Association guidelines were used as a basis for defining inadequate care, resulting in five categories: lifestyle management, immunization, pharmacologic therapy, laboratory evaluation, and physical examination. Prevalence was measured using descriptive statistics, and associated characteristics were measured using bivariate analysis. Results: The study cohort consisted of 1,665 individuals (survey weighted: 22,385,168). Results showed prevalence of 26%, 32%, 43%, 38%, and 28% of inadequate care for metrics lifestyle management, immunization, pharmacologic therapy, laboratory evaluation, and physical examination, respectively. Eighteen out of 19 of characteristics measured were associated with at least one category of inadequate care. Conclusion: Inadequate care is a pervasive issue in the management of T2D. In each of the five categories of inadequate care examined, prevalence was over 25%. Associated characteristics of inadequate care included systematic, physician, and patient factors. These findings suggest that additional research is warranted to further expand on the causes and consequences of inadequate care. Full Text: PDF DOI: 10.15640/ijhs.v9n4a1