855-P: The Relationship between Primary Care Providers’ Perceptions of Patient Motivation and Their Referral Practices for the National Diabetes Prevention Program Lifestyle Change Program

Abstract

Previous studies indicate that primary care providers’ (PCP) clinical decision making is affected by their perceptions of patient motivation. However, it is unclear how these perceptions affect PCP’s decisions to refer patients to community-based programs, such as the National Diabetes Prevention Program lifestyle change program (National DPP LCP), a structured, evidence-based, year-long lifestyle change program to prevent or delay onset of type 2 diabetes in adults with prediabetes or at risk of developing type 2 diabetes. Using data from the DocStyles 2018 web-based cross-sectional survey, we examined the relationship between PCP perceptions and referral practices. The following questions were asked to ascertain PCP perceptions and referral practices respectively: 1) “I need to make sure that my patients are motivated and ready to succeed in the National DPP LCP”; and 2) “Have you referred your patients with prediabetes to the in-person or online National DPP LCP to prevent or delay type 2 diabetes?” We analyzed the data using logistic regression analysis, with the final adjusted model controlling for PCP’s age, gender, practice years, PCP practitioner type, practice setting, and region. Our study sample included 1253 PCPs (46.3% female), with a mean age of 48.4 years and a mean practice duration of 17.4 years. We found that PCPs who realized the importance of patient motivation and readiness for their referral decision were more likely to refer their patients to the National DPP LCP, in both unadjusted (odds ratio [OR]=2.59, 95% confidence interval [CI]=1.85, 3.65) and adjusted (OR=2.58, 95% CI= 1.83, 3.64) models. Our findings highlight the importance of PCPs’ perceptions of patient motivation in their referral practices, suggesting that patient motivation and their PCP’s awareness of this motivation may need to be addressed to increase referrals to and enrollment in the National DPP LCP. Disclosure X. Zhang: None. M. Cannon: None. A. Lanza: None. T. Khan: None. M.C. Jackson: None. K. Nhim: None.