Encouraging Provider Referrals to Community Based Prediabetic Management Program in a Primary Care Setting

Background.Untreated prediabetes causes long-term health consequences. When untreated, prediabetes can develop into type 2 diabetes within five years. In the United States (U.S.), prediabetes affected over 80 million Americans in 2015 (e.g., one in three adults); 90 percent of adults do not know they have prediabetes. In Utah, there are currently 22 National Diabetes Prevention Programs (DPP) to manage prediabetes, including availability for employees and community members at the University of Utah Wellness Center. The National DPP focuses on lifestyle change include healthy eating and physical activity. Overall, the structured classes of the National DPP can prevent the onset of type 2 diabetes in reducing participants risk by 50 percent, for those over age 60 classes can prevent the onset of type 2 diabetes in reducing participants risk by 70 percent. The purpose of this project is to encourage provider referrals to community-based prediabetic management courses in a primary care setting. Methods.A pre-post survey approach was used to assess primary care provider awareness of community-based prediabetes classes and perceived barriers toward class referrals. An in-service was presented to alert providers to the content and location of classes and encourage provider referrals to prediabetes classes. After the presentation, preprinted prescription pads with locations of local classes were given to providers as a way to help them refer patients to classes, and count the number of referrals to local classes. Intervention effectiveness evaluated by measuring provider's pre and post-test knowledge and referral frequency before and after the in-service presentation. Results. The project site had a total of 15 participants. While many barriers were reported prior to the educational presentation, the most common barriers were a lack of visit time and a lack of awareness of prediabetic community-based programs. Pre-survey responses showed that 4 (44%) providers were aware of community-based prediabetic courses. Post-survey responses showed that 3 (75%) providers reported knowing that classes existed after the educational presentation (Table 2). Although the exact numbers of used referral prescriptions could not be obtained, the nurse manager reported that two providers took the referral prescription pads and used approximately 10-20 at another community clinic site. Conclusions.Despite limitations of a lack of a relationship with clinic personnel and the distant location of the clinic, primary care providers can play a critical role in preventing the onset of type 2 diabetes by partnering and supporting community-based diabetes prevention programs. The design of this project can be used in other community clinic sites to increase awareness and improve the provider's knowledge of community-based prediabetes classes. There is a great deal of evidence demonstrating that community based prediabetic management classes help prevent the onset of type 2 diabetes. Together, PCPs and community partners can help prevent the onset of type 2 diabetes, prevent diabetes-related complications, and improve quality of life for those with prediabetes.