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. 2024 Dec 28;16(12):e76527.
doi: 10.7759/cureus.76527. eCollection 2024 Dec.

Physician-Visit Frequency and Its Impact on Glycemic Control in People With Type 2 Diabetes: Quantifying Care Acceptance Parameters From Retrospective Electronic Health Record Data

Mukulesh Gupta  1 , Tanusree Gupta  2 , Tuhina Gupta  3
Affiliations

Physician-Visit Frequency and Its Impact on Glycemic Control in People With Type 2 Diabetes: Quantifying Care Acceptance Parameters From Retrospective Electronic Health Record Data

Mukulesh Gupta et al. Cureus. .

Abstract

Objective: Type 2 diabetes is a metabolic disorder characterized by insulin resistance and hyperglycemia affecting many individuals worldwide. For effective management, adherence to recommended physician visits is important, along with lifestyle modification and pharmacological interventions. Regular doctor visits can improve adherence and help prevent complications. This study examined how doctor-visit frequency impacts blood glucose (BG) control in people with type 2 diabetes.

Research design and methods: This retrospective, single-center study included adults with type 2 diabetes who had at least two visits and two hemoglobin A1c (HbA1c) values recorded at least 90 days apart between March 2019 and November 2023. Visit per quarter ratio (VQR) and the standardized delta HbA1c (ΔHbA1c) were defined. Data were analyzed for descriptive statistics and compared for significance between the groups. Statistical differences among the groups were determined using the Kruskal-Wallis test and Dwass-Steel-Critchlow-Fligner pairwise comparisons.

Results: Five hundred seventy-seven participants with type 2 diabetes were analyzed, with a mean age of 53.9 years (±12.7). The HbA1c outcome was significantly lower in the good compliance group (7.3%) than in the poor (7.7%). The high VQR group had a significantly lower HbA1c outcome (7.4%) than the low VQR group (7.7%); 50.98% (n = 104) in the low VQR group, 65.54% (n = 97) in the medium VQR group, and 60.44% (n = 136) in the high VQR group achieved HbA1c below the target. The mean ΔHbA1c was significantly lower in the good compliance group compared to the poor compliance group. The average follow-up durations were 11.22 quarters (±4.11) for low VQR, 9.75 quarters (±4.69) for medium VQR, and 5.50 quarters (±4.84) for high VQR.

Conclusion: A higher frequency of follow-up may be needed to encourage people with type 2 diabetes mellitus to visit their doctor regularly. The frequency of doctor visits has a positive impact on BG control. Regular visits enable timely adjustment of therapy and ensure high compliance with prescribed treatment. These findings have significant implications for mitigating nonadherence in chronic conditions like type 2 diabetes mellitus and warrant further investigation.

Keywords: doctor-patient rapport; electronic patient records; hemoglobin a1c (hba1c); patient compliance; standardized delta hba1c (δhba1c); type 2 diabetes; visit per quarter ratio (vqr); medication adherence.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Udyaan Healthcare Institutional Review Board issued approval Q-CAP/MG/23. Participants signed informed consent forms at registration, allowing the use of anonymized data for research. The study followed the ethical guidelines of the Indian Council of Medical Research (ICMR). Udyaan Healthcare Institutional Review Board (IRB) approved the study on July 25, 2023 (Q-CAP/MG/23). Written informed consent was obtained from all the patients who participated in the study. . Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Patient flow
HbA1c: hemoglobin A1c
See this image and copyright information in PMC

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