ArticleThe American journal of managed care2021
Patient need and provider referrals to diabetes self-management education.
Article in The American journal of managed care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
4 citing papers in PubMed, 8 citations in OpenAlex.
- The Value of Medical Nutrition Therapy and Diabetes Self-Management Education and Support in Diabetes Care and Education: A Call to Action to Increase Referrals and Recognize Insurance Coverage Variation.Current diabetes reports · 2025Review
- Medication Engagement, Determinants of Health, and A1C Levels Among Adults With Type 2 Diabetes within a Tribal Health System.The science of diabetes self-management and care · 2024Article
- Current evidence for designing self-management support for underserved populations: an integrative review using the example of diabetes.International journal for equity in health · 2023Review
- Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
objectivesThis study measured the likelihood of adult patients with diabetes being referred to diabetes self-management education (DSME) when "in need" according to clinical guidelines and identified which types of clinical need predict a greater likelihood of provider referral to DSME. STUDY
designThis repeated cross-sectional analysis utilized patient electronic health records (EHRs) and a statewide health information exchange database to examine a 7-year panel (2010-2016) of adult patients with diabetes. Our analytic sample included 8782 adult patients with diabetes with a total of 356,631 encounters.
methodsFixed-effects linear probability models with clustered robust standard errors estimated the association between patients' need for DSME and likelihood of being referred to the service. Models controlled for patients' health status, prior utilization, encounter setting, comorbidity risk scores, the state's expansion of Medicaid, and the count of accredited DSME program sites in the community.
resultsMost patient encounters indicated at least 1 type of need for DSME, but less than 7% of those encounters with a documented need resulted in a provider referral. In regression analysis, clinical indicators of need increased the likelihood that patients would be referred to DSME. Patients exhibiting multiple types of need were most likely to be referred to DSME.
conclusionsAlthough findings indicate that patient need for DSME does improve the likelihood of being referred, provider referral rates were significantly lower than anticipated. Future research should explore barriers to clinical guideline adherence and whether clinical decision support in EHR systems can facilitate provider referrals.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.