Barriers to A1C testing among a managed care population.
OBJECTIVE
The purpose of this study is to explore reasons adults with diabetes do not receive at least 2 A1C tests per year as recommended by the American Diabetes Association (ADA).


METHODS
ConnectiCare, a regional managed care company based in Farmington, Connecticut, identified adult members with diabetes who did not have a medical claim for an A1C laboratory test from their physician. A questionnaire was sent to 740 randomly selected members asking them to report the number of A1C tests they received in the past 12 months and reasons for not receiving the number of tests recommended by the ADA. After sending an automated telephone reminder to nonrespondents, a 26% (n = 192) response rate was achieved.


RESULTS
Thirty-three percent of respondents (n = 63) reported having diabetes and receiving fewer than 2 A1C tests in the past year. Respondents were equally divided between men and women, with a mean age of 58 years. The primary reasons given for not obtaining at least 2 A1C tests as recommended by the ADA were that respondents were unaware that the test is recommended (49%), not informed of the need for the test by their physician (38%), never heard of the A1C test (33%), and not seen regularly by their physician (19%).


CONCLUSIONS
Diabetes self-management education remains an important means of encouraging adherence to important ADA recommendations such as regular A1C testing. Barriers to A1C testing can be addressed in multiple settings, including individual and group education, disease management programs, and physician education.
Delaronde
Steven
S
Health Management Programs, ConnectiCare, Inc & Affiliates, Farmington, Connecticut 06032, USA. sdelaronde@connecticare.com
D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D003237:Connecticut; D003920:Diabetes Mellitus / Q000378:metabolism / Q000523:psychology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D015438:Health Behavior; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000592:standards*; D006301:Health Services Needs and Demand; D006801:Humans; D016015:Logistic Models; D008297:Male; D008329:Managed Care Programs / Q000592:standards*; D008875:Middle Aged; D009042:Motivation; D015999:Multivariate Analysis; D010353:Patient Education as Topic / Q000592:standards; D015397:Program Evaluation; D011787:Quality of Health Care / Q000592:standards; D011795:Surveys and Questionnaires
D006442:Glycated Hemoglobin