National Survey of Primary Care Physicians' Knowledge, Practices, and Perceptions of Prediabetes.
Level 4 - case-series / case-control
Cross-sectional survey
PubMed 31502095 · doi:10.1007/s11606-019-05245-7
What was done
A cross-sectional mailed survey was conducted among a nationally representative random sample of US primary care physicians (PCPs) selected from the American Medical Association Physician Masterfile. The survey assessed physician knowledge of screening risk factors, diagnostic laboratory criteria, and clinical recommendations for prediabetes, alongside practice behaviors, perceived barriers, and potential interventions. Associations between physician characteristics and outcomes were tested using chi-square and Fisher's exact tests.
What was found
A total of 298 eligible physicians responded (33% response rate). PCPs demonstrated limited knowledge of prediabetes risk factors, laboratory diagnostic criteria, and management guidelines. Only 36% of PCPs reported referring patients to a diabetes prevention lifestyle change program as their initial approach, whereas 43% reported discussing starting metformin. Physicians identified both individual-level barriers (e.g., patient motivation) and system-level barriers (e.g., lack of weight loss resources), indicating that increased access, insurance coverage, and referral coordination would facilitate prevention efforts.
Why it matters
The findings highlight substantial gaps in physician knowledge and low utilization of evidence-based lifestyle intervention programs for prediabetes, identifying clear targets for clinical education and health system reform.
Limits
The low response rate (33%) introduces potential non-response selection bias. Practice patterns and perceptions were self-reported rather than objectively verified through electronic health records. The abstract does not provide exact numeric test scores for physician knowledge.
Cited by
- supports Research indicates that approximately three-quarters of physicians cannot adequately assess prediabetes or metabolic disease.