SAT-LB029 Patient Participation Is Determined by Referral Source in an Intensive Diabetes Management Program

The HAC program was created for patients with high HbA1C values and consists of frequent visits, intensive pharmacologic management, and patient education. In this retrospective study, our primary objective was to determine if there are patient characteristics associated with participation in the program. We hypothesized that younger patients with shorter disease duration and lower HbA1C values would have higher rates of participation. The patients we evaluated were scheduled to begin the program between March and November 2018. Data regarding age, ethnicity, patient reported disease duration, HbA1C, and referral source were collected. We compared patients who participated in the program (Participants) and those who missed their first appointment or only attended one appointment (Non-participants). All Participants attended at least 2 appointments. A total of 30 patients were included, 19 patients in the Participant group and 11 patients in the Non-participant group. The Participant group had an average pre-enrollment HbA1C of 11.8% (8.7%-15.5%), average patient reported disease duration of 16.9 years (0.5-55 years), and average age of 55 years (32-78 years). 10/19 of patients in the Participant group were referred from an outpatient endocrinology clinic, 5/19 were referred from an inpatient endocrine service, and 4/19 were referred from a primary care setting. The Non-participant group had an average pre-enrollment HbA1C of 12.5% (10.2%-14.6%); average patient reported disease duration of 13.5 years (5-35 years), and average age of 53 years (32-65 years). 5/11 of patients in the Non-participant group were referred from an outpatient endocrinology clinic, 1/11 were referred from an inpatient medicine service, and 5/11 were referred from a primary care setting. There were 10 patients in the Participant group and 7 patients in the Non-participant group who had an HbA1C drawn 3 months after their initial enrollment. The Participant group’s HbA1C had a significant reduction to 8.6% (7.2%-10.5%) (p=0.0017). The average HbA1C in the Non-participant group did not change after 3 months and was 12.1% (9.3%-14.0%) Our program of intensive diabetes management, similar to what has been demonstrated in other studies, improved the glycemic outcomes in enrolled patients. In our HAC program, age, disease duration, and baseline HbA1C were not determinants of participation or improvement in glycemic control. More Participants were referred by an outpatient or inpatient endocrinology service. Patients’ motivation to participate may have been influenced by expectations set by the provider, acute illness, or the patient-provider relationship. Further studies to understand the impact of provider-patient relationships may help to optimize patient engagement in intensive diabetes management programs. Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. Abstracts presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.