705-P: Examining Psychosocial Correlates of HbA1c Testing Frequency

Evidence supports guidelines for quarterly HbA1c testing for optimum diabetes control. Understanding patient-level factors associated with testing frequency may inform future interventions. Previous research with insured patients found greater testing frequency was associated with older age, uncontrolled baseline HbA1c, and comorbidities. This secondary analysis used baseline survey data from an ongoing intervention trial with the first 383 adult Medicaid beneficiaries with type 2 diabetes to have 12 months of follow up and medical claims data. Participants had an HbA1c test date <4mo prior to enrollment and reported the value >7.0 or “don’t know”. Associations with ≤2 vs. 3+ test dates over 12 months and demographic, health, and psychosocial correlates were examined. Participants were female (77%), White (30%), Black (70%), age M=51.66 (SD=9.32), had M=2.90 social needs (SD=1.70), and including diabetes, had M=7.62 (SD=3.05) chronic conditions. Of 1,710 HbA1c claims; 119 were excluded for <30 days of a previous claim. Participants with 1-2 claims (N=110, 29%) were compared to those with 3+ claims (N=273, 71%). Greater testing frequency was associated (p<.05) with: less likelihood of having children at home, more likely to be on insulin, more likely to report an HbA1c >9.0 or “don’t know”, more compliant with diabetes medicine and glucose testing at home, poorer physical functioning and general health, less future time orientation, and more diabetes distress. Testing frequency was not associated with age, race, employment, disability, sum social needs, sum comorbidities, stress, depression, diabetes self-efficacy or social functioning. Only having children at home (OR=0.53; 95%CI 0.53-0.88) and future time orientation (OR=.50; 0.30-0.82) were significant in a multivariable model. Some participants with 3+ tests may be more engaged in better diabetes care due to fewer family demands. Others in better health with less diabetes distress may need messaging to increase the perceived need for quarterly testing. Disclosure A.Mcqueen: None. C.J.Herrick: Consultant; Teladoc Health, Other Relationship; Merck & Co., Inc., Eli Lilly and Company. L.Li: None. R.E.Smith: None. N.Verdecias: None. D.J.Broussard, jr.: None. D.A.Von nordheim: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (1R01DK115916-01)