Physicians' Self-Perceptions of Care for Emerging Adults with Type 1 Diabetes |
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| Institution: | 1. From the Department of Pediatrics, Division of Pediatric Endocrinology, Children''s Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania;2. Department of Medicine, Division of Endocrinology, University of Pittsburgh, Pittsburgh, Pennsylvania;3. Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania.;1. Pediatric Surgery, Helen DeVos Children''s Hospital, Grand Rapids, MI, United States;2. Anesthesia and Biostatistics, Boston Children''s Hospital, Boston, MA, United States;3. Pediatric Surgery, Boston Children''s Hospital, Boston, MA, United States;4. Pediatric Gastroenterology, Boston Children''s Hospital, Boston, MA, United States;1. USC Keck School of Medicine, Los Angeles, CA;2. University of Southern California University Center of Excellence for Developmental Disabilities, Los Angeles, CA;3. Los Angeles County Department of Public Health, Los Angeles, CA |
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| Abstract: | Objective: Establishing care with adult providers is essential for emerging adults with type 1 diabetes (T1D) transitioning from pediatric care. Although research evaluating the transition from pediatric to adult care has been focused primarily on patients' perceptions, little is known about the adult providers' perspectives. We sought to ascertain adult providers' perspectives of caring for the medical and psychosocial needs of this patient population.Methods: We developed and mailed a survey to 79 regional adult endocrinologists and 186 primary care physicians (PCPs) identified through 2 regional insurance plans. Questions addressed perceived aptitude in clinical aspects of diabetes management, importance and availability of diabetes team members, and opinions regarding recommended transition methods.Results: The response rate was 43% for endocrinologists and 13% for PCPs. Endocrinologists reported higher aptitude in insulin management (P<.01). PCPs reported greater aptitude in screening and treating depression (P<0.01). Although endocrinologists and PCPs did not differ in their views of the importance of care by a comprehensive team, endocrinologists reported better access to diabetes educators and dieticians than PCPs (P<.01). Recommended transition methods were described as useful.Conclusion: These preliminary results suggest that endocrinologists are better prepared to assume diabetes care of emerging adults, whereas PCPs may be better prepared to screen and treat associated depression. Future studies are needed to determine if a medical home model with cooperative management improves care for emerging adults with T1D.Abbreviations: T1D = type 1 diabetes CDE = certified diabetes educator RD = registered dietitian PCPs = primary care physicians |
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