ArticleBMJ quality & safety2021
Adherence to guideline-recommended HbA1c testing frequency and better outcomes in patients with type 2 diabetes: a 5-year retrospective cohort study in Australian general practice.
Article in BMJ quality & safety, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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26 citing papers in PubMed.
- HbA1c as a shared treatment goal in type 2 diabetes? A secondary analysis of the DEBATE trial.BMC primary care · 2023Trial
- Evaluation of a point-of-care testing platform against a laboratory HbA1c measurement method in a South African tertiary-level diabetes clinic.Practical laboratory medicine · 2026Article
- Clinical Effects of a Digital Health Intervention for Adults With Type 2 Diabetes in the United States: Retrospective Cohort Study.Journal of medical Internet research · 2026Article
- Evaluation of the relationship between glycated hemoglobin (HbA1c) levels and diabetes and other diseases: A retrospective study.Pakistan journal of medical sciences · 2026Article
- Pandemic Disruptions to Private Pathology Testing Uptake in Australia, 2019-2024.Pathogens (Basel, Switzerland) · 2025Article
- Nonadherence to Diabetes Complications Screening in a Multiethnic Asian Population: Protocol for a Mixed Methods Prospective Study.JMIR research protocols · 2025Article
- Association Between Non-adherence to Diabetes Management and Poor Sleep Quality Based on the Korean Community Health Survey.Journal of preventive medicine and public health = Yebang Uihakhoe chi · 2025Article
- A Home-Based Behaviour Change Intervention With Sedentary Behaviour and Physical Activity in People With Stroke and Diabetes-A Feasibility and Safety Study.Physiotherapy research international : the journal for researchers and clinicians in physical therapy · 2025Article
- Computer-Assisted Protocol-Adherent Blood Lipid Evaluation in Vascular Outpatients (CAPABLE-Vascular).Journal of clinical medicine · 2025Article
- Understanding the relationship between the frequency of HbA1c monitoring, HbA1c changes over time, and the achievement of targets: a retrospective cohort study.BMC endocrine disorders · 2025Article
- Impact of Order Restrictions on Hemoglobin A1c Requests at Primary Health Care Centers in Riyadh, Saudi Arabia.Risk management and healthcare policy · 2025Article
- Comparing the effectiveness and cost-effectiveness of alternative type 2 diabetes monitoring intervals in resource limited settings.Health policy and planning · 2024Article
- Individual, interpersonal, and community factors associated with health outcomes in patients with type 2 diabetes mellitus treated at federally qualified health centers.Journal of diabetes and metabolic disorders · 2024Article
- Determinants of sub-optimal glycemic control among patients enrolled in a medicine dispensing programme in KwaZulu-Natal: A cohort study, 2018-2021.African journal of primary health care & family medicine · 2024Article
- Short- and Long-Term Effects on Glucose Control of Nonadherence to Insulin Therapy in People With Type 2 Diabetes AnJournal of diabetes science and technology · 2024Article
- Assessment of Quality of Diabetic Care in Teaching Hospitals in Ethiopia: In Comparison to International Guidelines.Diabetes, metabolic syndrome and obesity : targets and therapy · 2024Article
- Population impact and cost-effectiveness of artificial intelligence-based diabetic retinopathy screening in people living with diabetes in Australia: a cost effectiveness analysis.EClinicalMedicine · 2024Article
- Effect of a Disease Management Program on the Adherence to Guideline-Recommended HbA1c Monitoring in Patients with Diabetes in Slovakia.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2023Article
- Gender gaps in type 1 diabetes care.Acta diabetologica · 2023Article
- Prevalence and characteristics of musculoskeletal complaints in primary care: an analysis from the population level and analysis reporting (POLAR) database.BMC primary care · 2023Article
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Abstract
backgroundClinical practice guidelines emphasise the role of regular monitoring of glycated haemoglobin A1c (HbA1c) for patients with type 2 diabetes, with most recommending 6-monthly testing. Nonetheless, there are few in-depth studies evaluating the clinical impact of the recommended testing frequency for patients to underpin the significance of guideline adherence.
objectiveThis study aimed to examine associations between patient outcomes and adherence to HbA1c testing frequencies recommended by Australian guidelines (6-monthly for patients with adequate glycaemic control and 3-monthly for patients with inadequate glycaemic control). The primary and secondary outcomes of interest were longitudinal changes in HbA1c values and development of ischaemic heart disease (IHD) and chronic kidney disease (CKD).
methodsThis 5-year retrospective cohort study (July 2013-June 2018) evaluated HbA1c testing frequency in a subset of patients with type 2 diabetes identified within data collected from approximately 250 Australian general practices. The study included patients who were aged ≥18 in 2013 and had a record of HbA1c testing in study practices during the study period. Each patient's adherence rate was defined by the proportion of HbA1c tests performed within the testing intervals recommended by Australian guidelines. Based on the adherence rate, adherence level was categorised into low (≤33%), moderate (34%-66%) and high (>66%). Generalised additive mixed models were used to examine associations between adherence to the recommended HbA1c testing frequency and patient outcomes.
resultsIn the 6424 patients with diabetes, the overall median HbA1c testing frequency was 1.6 tests per year with an adherence rate of 50%. The estimated HbA1c levels among patients with low adherence gradually increased or remained inadequately controlled, while HbA1c values in patients with high adherence remained controlled or improved over time. The risk of developing CKD for patients with high adherence was significantly lower than for patients with low adherence (OR: 0.42, 95% CI 0.18 to 0.99). No association between IHD and adherence to the recommended HbA1c frequency was observed.
conclusionBetter adherence to guideline-recommended HbA1c testing frequency was associated with better glycaemic control and lower risk of CKD. These findings may provide valuable evidence to support the use of clinical guidelines for better patient outcomes in patients with type 2 diabetes.
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