論文

査読有り
2021年9月

Association between nutritional guidance or ophthalmological examination and discontinuation of physician visits in patients with newly diagnosed diabetes: A retrospective cohort study using a nationwide database.

Journal of diabetes investigation
  • Akira Okada
  • Sachiko Ono
  • Satoko Yamaguchi
  • Hayato Yamana
  • Kayo Ikeda Kurakawa
  • Nobuaki Michihata
  • Hiroki Matsui
  • Masaomi Nangaku
  • Toshimasa Yamauchi
  • Hideo Yasunaga
  • Takashi Kadowaki
  • 全て表示

12
9
開始ページ
1619
終了ページ
1631
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1111/jdi.13510

AIMS/INTRODUCTION: Discontinuation of diabetes care has been studied mostly in patients with prevalent diabetes and not in patients with newly diagnosed diabetes, whose dropout risk is highest. Because enrolling patients in a prospective study will influence adherence, we retrospectively examined whether guideline-recommended practices, defined as nutritional guidance or ophthalmological examination, can prevent patient discontinuation of diabetes care after its initiation. MATERIALS AND METHODS: We retrospectively identified adults with newly screened diabetes during checkups using a large Japanese administrative claims database (JMDC, Tokyo, Japan) that contains laboratory data and lifestyle questionnaires. We defined discontinuation of physician visits as a follow-up interval exceeding 6 months. We divided the patients into those who received guideline-recommended practices (nutritional guidance or ophthalmology consultation) within the same month as the first visit and those who did not. We calculated propensity scores and carried out inverse probability of treatment weighting analyses to compare discontinuation between the two groups. RESULTS: We identified 6,508 patients with at least one physician consultation for diabetes care within 3 months after their checkup, including 4,574 patients without and 1,934 with guideline-recommended practices. After inverse probability of treatment weighting, patients with guideline-recommended practices had a significantly lower proportion of discontinuation than those without (17.2% vs 21.8%; relative risk 0.79, 95% confidence interval 0.69-0.91). CONCLUSIONS: This study is the first to show that after adjustment for both patient and healthcare provider factors, guideline-recommended practices within the first month of physician consultation for diabetes care can decrease subsequent discontinuation of physician visits in patients with newly diagnosed diabetes.

リンク情報
DOI
https://doi.org/10.1111/jdi.13510
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/33459533
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8409872
ID情報
  • DOI : 10.1111/jdi.13510
  • PubMed ID : 33459533
  • PubMed Central 記事ID : PMC8409872

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