Addressing Lifestyle Management During Visits Involving Patients with Prediabetes: NAMCS 2013-2015.

Background: The gap between treatment guidelines and clinical practice in prediabetes management has been identified in previous studies. The knowledge related to addressing lifestyle change during office visits in clinical practice to manage prediabetes is limited.

Objective: To describe patterns of lifestyle management addressed during office-based visits involving patients with prediabetes and identify factors associated with addressing lifestyle management during physician office visits in the USA.

Design: Cross-sectional study PARTICIPANTS: US National Ambulatory Medical Care Survey (NAMCS) data from 2013 to 2015 were combined to identify office-based visits involving patients with prediabetes.

Main Measures: The major outcome is lifestyle management including diet/nutrition, exercise, and/or weight reduction. Patient and physician characteristics were collected for analysis. The prevalence and patterns of addressing lifestyle management during visits were estimated and described. Multivariate logistic regression model identified significant factors associated with lifestyle management. The patient visit weight was applied to all analyses to achieve nationally representative estimates.

Key Results: Among 4039 office-based visits involving patients with prediabetes between 2013 and 2015, 22.8% indicated lifestyle management was addressed during the visits. Diet/nutrition, exercise, and weight reduction accounted for 86.1%, 62.6%, and 34.1% of the visits with lifestyle management addressed, respectively. Lifestyle management was more likely to be addressed during the visits involving patients with hyperlipidemia (OR = 1.74, 95% CI 1.24-2.46) and obesity (OR = 4.03, 95% CI 2.91-5.56), seeing primary physicians (vs. other specialties, OR = 1.46, 95% CI 1.03-2.08), and living in the southern region (vs. northeast, OR = 1.96, 95% CI 1.20-3.19).

Conclusions: The prevalence of addressing lifestyle management during office visits involving patients with prediabetes remained low in the USA. Patients' clinical characteristics, geographic region, and physician's specialty were associated with addressing lifestyle management during the visits.