Patient and practice factors associated with HbA1c testing frequency in patients with type 2 diabetes: a retrospective cohort study in Australian general practice.

BACKGROUND:Better adherence to guideline-recommended glycated haemoglobin A1c (HbA1c) testing frequency is associated with better glycaemic control and lower risk of complications such as chronic kidney disease in patients with type 2 diabetes. This study investigates patient and practice factors associated with adherence to guideline-recommended HbA1c testing frequency. METHODS:A cohort of type 2 diabetes patients who regularly visited general practices from 2012 to 2018 was identified from 225 Australian general practices. With the goal of ≤53mmol/mol, Australian guidelines recommend HbA1c testing at least 6-monthly. Patient history of HbA1c tests from 2017 to 2018 was used to define adherence to guidelines, and the associations with patient and practice factors were examined by regression models. RESULTS:Of the 6881 patients, 2186 patients (31.8%) had 6-monthly HbA1c testing. Patient age and anti-diabetic medications were associated with adherence to 6-monthly testing. When financial incentives are available to practices, a larger practice was associated with better adherence to 6-monthly testing. CONCLUSIONS:The identified key factors such as age, practice size, medication, and incentive payments can be used to target initiatives aimed at improving guideline-recommended monitoring care for patients with type 2 diabetes to enhance their health outcomes.