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
Abstract 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 exa...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-09-01
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| Series: | Journal of Diabetes Investigation |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jdi.13510 |
| _version_ | 1818956225392410624 |
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| author | Akira Okada Sachiko Ono Satoko Yamaguchi Hayato Yamana Kayo Ikeda Kurakawa Nobuaki Michihata Hiroki Matsui Masaomi Nangaku Toshimasa Yamauchi Hideo Yasunaga Takashi Kadowaki |
| author_facet | Akira Okada Sachiko Ono Satoko Yamaguchi Hayato Yamana Kayo Ikeda Kurakawa Nobuaki Michihata Hiroki Matsui Masaomi Nangaku Toshimasa Yamauchi Hideo Yasunaga Takashi Kadowaki |
| author_sort | Akira Okada |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-20T10:50:34Z |
| format | Article |
| id | doaj.art-feb70a8cc5f945dc9daaf08285a8e580 |
| institution | Directory Open Access Journal |
| issn | 2040-1116 2040-1124 |
| language | English |
| last_indexed | 2024-12-20T10:50:34Z |
| publishDate | 2021-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Investigation |
| spelling | doaj.art-feb70a8cc5f945dc9daaf08285a8e5802022-12-21T19:43:18ZengWileyJournal of Diabetes Investigation2040-11162040-11242021-09-011291619163110.1111/jdi.13510Association between nutritional guidance or ophthalmological examination and discontinuation of physician visits in patients with newly diagnosed diabetes: A retrospective cohort study using a nationwide databaseAkira Okada0Sachiko Ono1Satoko Yamaguchi2Hayato Yamana3Kayo Ikeda Kurakawa4Nobuaki Michihata5Hiroki Matsui6Masaomi Nangaku7Toshimasa Yamauchi8Hideo Yasunaga9Takashi Kadowaki10Department of Prevention of Diabetes and Lifestyle‐Related Diseases Graduate School of Medicine The University of Tokyo Tokyo JapanDepartment of Eat‐loss Medicine Graduate School of Medicine The University of Tokyo Tokyo JapanDepartment of Prevention of Diabetes and Lifestyle‐Related Diseases Graduate School of Medicine The University of Tokyo Tokyo JapanDepartment of Health Services Research Graduate School of Medicine The University of Tokyo Tokyo JapanDepartment of Prevention of Diabetes and Lifestyle‐Related Diseases Graduate School of Medicine The University of Tokyo Tokyo JapanDepartment of Health Services Research Graduate School of Medicine The University of Tokyo Tokyo JapanDepartment of Clinical Epidemiology and Health Economics The University of Tokyo Tokyo JapanDivision of Nephrology and Endocrinology Graduate School of Medicine The University of Tokyo Tokyo JapanDepartment of Diabetes and Metabolism Graduate School of Medicine The University of Tokyo Tokyo JapanDepartment of Clinical Epidemiology and Health Economics The University of Tokyo Tokyo JapanDepartment of Prevention of Diabetes and Lifestyle‐Related Diseases Graduate School of Medicine The University of Tokyo Tokyo JapanAbstract 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.https://doi.org/10.1111/jdi.13510AdherenceClinical epidemiologyNutrition guidance |
| spellingShingle | Akira Okada Sachiko Ono Satoko Yamaguchi Hayato Yamana Kayo Ikeda Kurakawa Nobuaki Michihata Hiroki Matsui Masaomi Nangaku Toshimasa Yamauchi Hideo Yasunaga Takashi Kadowaki 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 Adherence Clinical epidemiology Nutrition guidance |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Adherence Clinical epidemiology Nutrition guidance |
| url | https://doi.org/10.1111/jdi.13510 |
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