title: Follow-up with primary care providers for elevated glycated haemoglobin identified at the dental visit.
abstract: OBJECTIVE
  This study examined patient experiences after receiving elevated diabetes screening values using blood collected at a dental clinic. It explores patients' reactions to screening, whether or not they sought recommended medical follow-up, and facilitating factors and barriers to obtaining follow-up care.
  
  
  METHODS
  At the comprehensive care clinics at a large, urban College of Dentistry in the United States, haemoglobin A1C (HbA1C) values were obtained from 379 study participants who had not been previously diagnosed with diabetes. In all, 169 (44.6%) had elevated HbA1C values. We analysed quantitative and qualitative data concerning these patients' follow-up with primary care providers (PCPs).
  
  
  RESULTS
  We were able to contact 112 (66.3%) of the 169 study participants who had an elevated HbA1C reading. Of that group, 61 (54.5%) received recommended follow-up care from a PCP within 3 months, and an additional 28 (25.0%) said they intended to seek such care. Qualitative themes included the following: the screening letter - opportunity or burden, appreciation for the 3-month follow-up call and barriers to medical follow-up that included the following: lack of knowledge about diabetes, not understanding the importance of follow-up, busyness, financial concerns, fear and denial.
  
  
  CONCLUSIONS
  Quantitative and qualitative data demonstrate that dentists, dental hygienists and nurses are well poised to discover and translate new models of patient-centred, comprehensive care to patients with oral and systemic illness.
authors.affiliation: New York University College of Nursing and Department of Psychiatry, New York University School of Medicine, New York, NY, USA.
authors.forename: M T
authors.initials: MT
authors.lastname: Rosedale
authors.affiliation: New York University College of Nursing, New York, NY, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Strauss
authors.affiliation: New York University College of Nursing, New York, NY, USA.
authors.forename: N
authors.initials: N
authors.lastname: Kaur
authors.affiliation: New York University College of Nursing, New York, NY, USA.
authors.forename: C
authors.initials: C
authors.lastname: Knight
authors.affiliation: Department of Psychiatry, New York University School of Medicine, New York, NY, USA.
authors.forename: D
authors.initials: D
authors.lastname: Malaspina
mesh_terms: D000293:Adolescent; D000328:Adult; D003266:Continuity of Patient Care; D003740:Dental Clinics; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York; D010349:Patient Compliance; D011320:Primary Health Care / Q000706:statistics & numerical data*; D014481:United States
chemical_list: D006442:Glycated Hemoglobin
keywords: dentistry; diabetes; interprofessional collaboration; mixed-methods research; nursing; prediabetes; screening