Nutritional guidance, ophthalmologic consultations prevent healthcare discontinuation among diabetics

Guideline-recommended practices, such as nutritional guidance or ophthalmology consultations, can help prevent the discontinuation of physician visits among patients with newly diagnosed diabetes, a new study has found.

The researchers retrospectively examined the data of 6,508 diabetics who had at least one consultation for diabetes care within 3 months after their most recent check-up. Discontinuation of visits was defined as a follow-up interval longer than 6 months. Participant data were retrieved from the Japanese administrative claims database.

Of the participants, 1,934 received either an ophthalmological examination or nutritional guidance from their physician within a month of their first visit, while the remaining 4,574 did not. Regression analysis showed that patients who had been given such guidance were less likely to discontinue physician visits (weighted: 17.2 percent vs 21.8 percent).

After inverse probability of treatment weighting (IPTW), the resulting risk estimate of discontinuation remained significantly lowered in those who had been exposed to guideline-recommended practices (relative risk [RR], 0.79, 95 percent confidence interval [CI], 0.69–0.91; p=0.001).

Taking each guideline component into consideration, the researchers found that nutritional guidance had a stronger effect, such that those who had been exposed to such guidance were 25-percent less likely to discontinue physician visits after IPTW (RR, 0.75, 95 percent CI, 0.62–0.90; p=0.002). No such effect was reported for ophthalmological examination (after IPTW: RR, 0.93, 95 percent CI, 0.74–1.17; p=0.551).

“These findings can shed light on diabetes practice and reinforce the importance of implementing guideline-recommended practices from the early stage of diabetes care,” the researchers said.