Concordance of provider recommendations with American Diabetes Association's Guidelines.
OBJECTIVE
To determine if selected client characteristics were factors influencing the provision of provider advice for diet, exercise, smoking cessation, alcohol cessation, eye and foot care, and influenza and pneumonia vaccine for those told by a provider that they had diabetes.


METHODS
Data from the 2001 National Health Interview Survey were used in a secondary analysis to answer the research question. This study used a subsample who self-reported having provider-diagnosed diabetes; the subsample comprised 2287 unweighted subjects that, when weighted, represent 6.38% of the civilian noninstitutionalized individuals with diabetes in the United States.


CONCLUSIONS
This study suggests that many patients are not receiving all the eight processes of care studied, particularly those with new onset diabetes, elders, black people, and Hispanics.


CONCLUSIONS
This study suggests that the present paradigm is not early prevention but treatment of established disease. Changes in entrenched thinking about clinical care need to be addressed. Patients with diabetes need to have an awareness that there is a standard of optimal care, and they should be encouraged to seek those who provide this care. Further, system changes may be required to address changes that are not easily made at the provider level.
Morritt Taub
Leslie-Faith
LF
School of Nursing, University of Medicine and Dentistry of New Jersey, Newark, NJ 07101, USA. taublm@umdnj.edu
D001294:Attitude to Health; D017281:Cost of Illness; D003920:Diabetes Mellitus / Q000517:prevention & control* / Q000523:psychology; D017719:Diabetic Foot / Q000175:diagnosis / Q000517:prevention & control; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000517:prevention & control; D003927:Diet, Diabetic; D015444:Exercise; D005260:Female; D019983:Guideline Adherence / Q000592:standards*; D019538:Health Care Surveys; D006301:Health Services Needs and Demand; D006801:Humans; D016015:Logistic Models; D008297:Male; D017146:Models, Organizational; D010043:Outcome and Process Assessment, Health Care / Q000458:organization & administration*; D010353:Patient Education as Topic / Q000592:standards*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards; D019984:Quality Indicators, Health Care; D016540:Smoking Cessation; D011795:Surveys and Questionnaires; D013597:Systems Analysis; D014481:United States; D014611:Vaccination / Q000592:standards