The effects of a patient-based risk assessment prompt on diabetes screening

Objective: Previous research has determined that nurse-based diabetes risk assessment increases screening and preventive services for patients at risk for type 2 diabetes. This pilot study tested the impact of a diabetes risk assessment completed by patients without nursing assistance. Research design and methods: Patients from a family medicine residency clinic completed an American Diabetes Association Risk Assessment questionnaire. Intervention subjects presented completed questionnaires to their physicians. Control subjects returned the questionnaire to the research assistant. Primary endpoints were the number of persons receiving diabetes screening and the number of persons with newly diagnosed diabetes. The associations between the intervention and diabetes screening and diagnosis were assessed using univariate and multivariate logistic regression models. Results: This study included 511 subjects (256 in the intervention group and 255 in the control group). Comparing intervention to control subjects, there was no difference in fasting glucose screening rates. However, odds of diabetes diagnoses were significantly higher using univariate analysis (OR 5.2; 95% CI 1.1-24.3, p = .036) and approached statistical significance after adjusting for other risk factors (OR 4.6; 95% CI 0.92-23.2, p = .063). Conclusions: A simple patient-based risk assessment used in the outpatient setting may represent a simple, economical method for discovering previously-undiagnosed type 2 diabetes.