Leveraging the Electronic Medical Record to Identify Predictors of Nonattendance to a Diabetes Self-Management Education and Support Program.

Abstract

The purpose of this study is to identify patient-specific factors, easily obtainable from the electronic medical record (EMR), that are associated with nonattendance to a group Diabetes Self-Management Education and Support (DSMES) program among an adult population with type 2 diabetes. This study used a retrospective cohort design, with attendance to a group DSMES session as the primary outcome. The study included adult patients with diagnosed type 2 diabetes who were scheduled for a group DSMES session between March 1, 2013, and June 30, 2017. Patients who were pregnant or who had other types of diabetes (eg, type 1 diabetes, prediabetes, gestational diabetes) were excluded. A higher A1C, required copay for DSMES, low socioeconomic status, increased number of diabetes medications prescribed, the presence of a prescription for any insulin, and a higher calculated total daily dose of insulin were all associated with a decreased likelihood of attendance. Only older age was associated with an increased likelihood of attendance. Using the EMR to identify patients who need more intensive intervention strategies can help programs direct resources to those who need them most. Having identified these at-risk individuals, a targeted communication and outreach strategy can be developed to assist these individuals with overcoming barriers to attending DSMES.