Family Medicine and Community Health最新文献

{"title":"Trustworthy evidence-based versus untrustworthy guidelines: detecting the difference.","authors":"João Pedro Lima,&nbsp;Wimonchat Tangamornsuksan,&nbsp;Gordon H Guyatt","doi":"10.1136/fmch-2023-002437","DOIUrl":"10.1136/fmch-2023-002437","url":null,"abstract":"<p><p>Guidelines are essential tools in healthcare decision-making. Trustworthy guidelines inform clinicians not only on the direction (against or in favour) and strength (strong or weak/conditional) of recommendations but also on the certainty of the underlying evidence. Developing trustworthy guidelines requires panellists with clinical and methodological expertise who consider patients' values and preferences. Adherence to trustworthiness standards remains variable; clinicians should, therefore, be able to distinguish trustworthy from untrustworthy guidelines. In this paper, we offer eight domains of disparities between trustworthy evidence-based guidelines and less trustworthy guidelines.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"11 4","pages":""},"PeriodicalIF":6.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c7/7d/fmch-2023-002437.PMC10565152.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41139475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time trend and seasonality in medically attended respiratory syncytial virus (RSV) infections in US children aged 0-5 years, January 2010-January 2023.","authors":"Lindsey Wang, Nathan Berger, Pamela B Davis, David C Kaelber, Nora Volkow, Rong Xu","doi":"10.1136/fmch-2023-002453","DOIUrl":"10.1136/fmch-2023-002453","url":null,"abstract":"<p><strong>Objective: </strong>The long-term time trend and seasonality variations of first-time medically attended respiratory syncytial virus (RSV) infections among young children are unknown. We aim to examine the time trend of medically attended first-time RSV infections among young children in the USA from January 2010 through January 2023.</p><p><strong>Design: </strong>This is a population-based cohort study using electronic health records (EHRs). Monthly incidence rate of medically attended first-time RSV infection (cases per 10 000 000 person-days). A time-series regression model was used to model and predict time trends and seasonality.</p><p><strong>Setting: </strong>Multicenter and nationwide TriNetX Network in the USA.</p><p><strong>Participants: </strong>The study population comprised children aged 0-5 years who had medical visits during the period of January 2010 to January 2023.</p><p><strong>Results: </strong>The data included 29 013 937 medical visits for children aged 0<b>-</b>5 years (46.5% girls and 53.5% boys) from January 2010 through January 2023. From 2010 through 2019, the monthly incidence rate of first-time medically attended RSV infection in children aged 0<b>-</b>5 years followed a consistent seasonal pattern. Seasonal patterns of medically attended RSV infections were significantly disrupted during the COVID-19 pandemic. In 2020, the seasonal variation disappeared with a peak incidence rate of 20 cases per 1 000 000 person-days, a decrease of 97.4% from the expected peak rate (rate ratio or RR: 0.026, 95% CI 0.017 to 0.040). In 2021, the seasonality returned but started 4 months earlier, lasted for 9 months, and peaked in August at a rate of 753 cases per 1 000 000 person-days, a decrease of 9.6% from the expected peak rate (RR: 0.90, 95% CI 0.82 to 0.99). In 2022, the seasonal pattern is similar to prepandemic years but reached a historically high rate of 2182 cases per 10 000 000 person-days in November, an increase of 143% from the expected peak rate (RR: 2.43, 95% CI 2.25 to 2.63). The time trend and seasonality of the EHR-based medically attended RSV infections are consistent with those of RSV-associated hospitalisations from the Centers for Disease Control and Prevention (CDC) survey-based surveillance system.</p><p><strong>Conclusion: </strong>The findings show the disrupted seasonality during the COVID-19 pandemic and a historically high surge of paediatric RSV cases that required medical attention in 2022. Our study demonstrates the potential of EHRs as a cost-effective alternative for real-time pathogen and syndromic surveillance of unexpected disease patterns including RSV infection.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"11 4","pages":""},"PeriodicalIF":6.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/09/ef/fmch-2023-002453.PMC10582996.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time to treat the climate and nature crisis as one indivisible global health emergency.","authors":"Chris Zielinski","doi":"10.1136/fmch-2023-002562","DOIUrl":"10.1136/fmch-2023-002562","url":null,"abstract":"","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"11 4","pages":""},"PeriodicalIF":6.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10603346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50163190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Priorities for research on family planning impact: recommendations of a WHO Think Tank meeting.","authors":"Moazzam Ali, James Kiarie, Iqbal Shah","doi":"10.1136/fmch-2023-002406","DOIUrl":"10.1136/fmch-2023-002406","url":null,"abstract":"","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"11 4","pages":""},"PeriodicalIF":6.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ff/40/fmch-2023-002406.PMC10565323.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41215452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying depression and its determinants upon initiating treatment: ChatGPT versus primary care physicians.","authors":"Inbar Levkovich,&nbsp;Zohar Elyoseph","doi":"10.1136/fmch-2023-002391","DOIUrl":"10.1136/fmch-2023-002391","url":null,"abstract":"<p><strong>Objective: </strong>To compare evaluations of depressive episodes and suggested treatment protocols generated by Chat Generative Pretrained Transformer (ChatGPT)-3 and ChatGPT-4 with the recommendations of primary care physicians.</p><p><strong>Methods: </strong>Vignettes were input to the ChatGPT interface. These vignettes focused primarily on hypothetical patients with symptoms of depression during initial consultations. The creators of these vignettes meticulously designed eight distinct versions in which they systematically varied patient attributes (sex, socioeconomic status (blue collar worker or white collar worker) and depression severity (mild or severe)). Each variant was subsequently introduced into ChatGPT-3.5 and ChatGPT-4. Each vignette was repeated 10 times to ensure consistency and reliability of the ChatGPT responses.</p><p><strong>Results: </strong>For mild depression, ChatGPT-3.5 and ChatGPT-4 recommended psychotherapy in 95.0% and 97.5% of cases, respectively. Primary care physicians, however, recommended psychotherapy in only 4.3% of cases. For severe cases, ChatGPT favoured an approach that combined psychotherapy, while primary care physicians recommended a combined approach. The pharmacological recommendations of ChatGPT-3.5 and ChatGPT-4 showed a preference for exclusive use of antidepressants (74% and 68%, respectively), in contrast with primary care physicians, who typically recommended a mix of antidepressants and anxiolytics/hypnotics (67.4%). Unlike primary care physicians, ChatGPT showed no gender or socioeconomic biases in its recommendations.</p><p><strong>Conclusion: </strong>ChatGPT-3.5 and ChatGPT-4 aligned well with accepted guidelines for managing mild and severe depression, without showing the gender or socioeconomic biases observed among primary care physicians. Despite the suggested potential benefit of using atificial intelligence (AI) chatbots like ChatGPT to enhance clinical decision making, further research is needed to refine AI recommendations for severe cases and to consider potential risks and ethical issues.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"11 4","pages":""},"PeriodicalIF":6.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6f/f6/fmch-2023-002391.PMC10582915.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The 2020 US cancer screening deficit and the timing of adults' most recent screen: a population-based cross-sectional study.","authors":"Jason Semprini,&nbsp;Radhika Ranganathan","doi":"10.1136/fmch-2022-001893","DOIUrl":"https://doi.org/10.1136/fmch-2022-001893","url":null,"abstract":"<p><strong>Objective: </strong>In 2020, cancer screenings declined, resulting in a cancer screening deficit. The significance of this deficit, however, has yet to be quantified from a population health perspective. Our study addresses this evidence gap by examining how the pandemic changed the timing of American adults' most recent cancer screen.</p><p><strong>Methodology: </strong>We obtained population-based, cancer screening data from the Behavioural Risk Factor Surveillance System (BRFSS) (2010, 2012, 2014, 2016, 2018, 2020). Mammograms, pap smears and colonoscopies were each specified as a variable of mutually exclusive categories to indicate the timing since the most recent screening (never, 0-1 years, 1-2 years, 3+ years). Our cross-sectional, quasi-experimental design restricts the sample to adults surveyed in January, February or March. We then leverage a quirk in the BRFSS implementation and consider adults surveyed in the second year of the 2020 survey wave as exposed to the COVID-19 pandemic. Respondents surveyed in January 2020-March 2020 were considered unexposed. To estimate the impact of exposure to the COVID-19 pandemic on the timing of recent cancer screenings, we constructed linear and logistic regression models which control for sociodemographic characteristics associated with screening patterns, and state fixed effects and temporal trend fixed effects to control for confounding.</p><p><strong>Results: </strong>In 2020, the cancer screening deficit was largely due to a 1 year delay among adults who receive annual screening, as the proportion of adults reporting a cancer screen in the past year declined by a nearly identical proportion of adults reporting their most recent cancer screen 1-2 years ago (3%-4% points). However, the relative change was higher for mammograms and pap smears (17%) than colonoscopies (4%). We also found some evidence that the proportion of women reporting never having completed a mammogram declined in 2020, but the mechanisms for this finding should be further explored with the release of future data.</p><p><strong>Conclusion: </strong>Our estimates for the pandemic's effect on cancer screening rates are smaller than prior studies. Because we account for temporal trends, we believe prior studies overestimated the effect of the pandemic and underestimated the overall downward trend in cancer screenings across the country leading up to 2020.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"11 3","pages":""},"PeriodicalIF":6.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/27/af/fmch-2022-001893.PMC10510914.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41154947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FamilyCoviDD19: results of a cross-sectional study-long-term outcomes of infected and uninfected household members.","authors":"Theresa S Horst,&nbsp;Jakob P Armann,&nbsp;Maren Doenhardt,&nbsp;Svenja Dreßen,&nbsp;Paula Czyborra,&nbsp;Josephine Schneider,&nbsp;Christin Gano,&nbsp;Alexander Dalpke,&nbsp;Christian Lück,&nbsp;Annet Bluschke,&nbsp;Magdalena Wekenborg,&nbsp;Reinhard Berner,&nbsp;Judith Blankenburg","doi":"10.1136/fmch-2022-002057","DOIUrl":"https://doi.org/10.1136/fmch-2022-002057","url":null,"abstract":"<p><strong>Objective: </strong>In this study, we aimed to compare long-term physical and mental health outcome between SARS-CoV-2 infected and uninfected household members to differentiate between infection-related and pandemic-related outcomes after about two and a half years of the pandemic. Furthermore, possible differences in the outcome of adults and children and young people (CYP) were of interest.</p><p><strong>Design: </strong>In a cross-sectional study design, we compared the long-term physical and mental health outcome of between infected and uninfected as well as between adult and CYP (household members).</p><p><strong>Setting: </strong>The FamilyCoviDD19 study-a serology study in households-was initially conducted to evaluate virus transmission in a close contact setting focusing on households with children and adolescents in Germany. At least 1 year after initial infection in the respective households, a follow-up took place in which the prevalence and type of possible long-term consequences were surveyed on the basis of self-reported information on physical and mental health.</p><p><strong>Participant: </strong>In this study, a total of 533 household members of 146 families participated and responded to our survey, including 296 (55.5%) adults and 237 (44.5%) CYP.</p><p><strong>Result: </strong>The difference in frequency of reported symptoms between infected and uninfected individuals was very moderate, suggesting that the vast majority of reported symptoms were not attributable to a previous SARS-CoV-2 infection. However, regardless of age and infection status, this study showed overall high rates of self-reported symptoms with CYP having fewer long-term sequelae than adults one year after infection. Furthermore, over 50% of those reporting symptoms were not affected in their daily life, with CYPs reporting an even lower percentage compared with adults.</p><p><strong>Conclusion: </strong>CYP are at reduced risk not only to develop symptomatic infection or severe disease courses (previous analyses) but also to develop infection-associated long-term sequelae (this study). Independent of infection CYP reported high rates of neurocognitive, pain, somatic and mood symptoms, which makes the influence of the pandemic itself-including pandemic control measures-decisive.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"11 3","pages":""},"PeriodicalIF":6.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/de/54/fmch-2022-002057.PMC10476124.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10595806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health centres and social determinants of health: an analysis of enabling services provision and clinical quality.","authors":"Michael Topmiller,&nbsp;Jessica McCann,&nbsp;Hank Hoang,&nbsp;Jennifer Rankin,&nbsp;Jene Grandmont,&nbsp;Molly Pelzer,&nbsp;Alek Sripipatana","doi":"10.1136/fmch-2023-002227","DOIUrl":"10.1136/fmch-2023-002227","url":null,"abstract":"<p><strong>Objective: </strong>It is well known that social determinants of health (SDOH), including poverty, education, transportation and housing, are important predictors of health outcomes. Health Resources and Services Administration (HRSA)-funded health centres serve a patient population with high vulnerability to barriers posed by SDOH and are required to provide services that enable health centre service utilisation and assist patients in navigating barriers to care. This study explores whether health centres with higher percentages of patients using these enabling services experience better clinical performance and outcomes.</p><p><strong>Design and setting: </strong>The analysis uses organisational characteristics, patient demographics and clinical quality measures from HRSA's 2018 Uniform Data System. Health centres (n=875) were sorted into quartiles with quartile 1 (Q1) representing the lowest utilisation of enabling services and quartile 4 (Q4) representing the highest. The researchers calculated a service area social deprivation score weighted by the number of patients for each health centre and used ordinary least squares to create adjusted values for each of the clinical quality process and outcome measures. Analysis of variance was used to test differences across enabling services quartiles.</p><p><strong>Results: </strong>After adjusting for patient characteristics, health centre size and social deprivation, authors found statistically significant differences for all clinical quality process measures across enabling services quartiles, with Q4 health centres performing significantly better than Q1 health centres for several clinical process measures. However, these Q4 health centres performed poorer in outcome measures, including blood pressure and haemoglobin A1c control.</p><p><strong>Conclusion: </strong>These findings emphasise the importance of how enabling services (eg, translation services, transportation) can address unmet social needs, improve utilisation of health services and reaffirm the challenges inherent in overcoming SDOH to improve health outcomes.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"11 3","pages":""},"PeriodicalIF":6.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9b/5b/fmch-2023-002227.PMC10546097.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41113180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Absolute cardiovascular risk assessment by Australian early-career general practitioners: a cross-sectional study.","authors":"Toby Morgan,&nbsp;Anna Ralston,&nbsp;Andrew Davey,&nbsp;Elizabeth G Holliday,&nbsp;Mark Nelson,&nbsp;Alison Fielding,&nbsp;Mieke van Driel,&nbsp;Amanda Tapley,&nbsp;Dominica Moad,&nbsp;Jean Ball,&nbsp;Jennifer Presser,&nbsp;Neil Spike,&nbsp;Parker Magin","doi":"10.1136/fmch-2023-002251","DOIUrl":"https://doi.org/10.1136/fmch-2023-002251","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prevalence and associations of general practice registrars' performing absolute cardio-vascular risk (ACVR) assessment (ACVRa).</p><p><strong>Design: </strong>A cross-sectional study employing data (2017-2018) from the Registrar Clinical Encounters in Training project, an ongoing inception cohort study of Australian GP registrars. The outcome measure was whether an ACVRa was performed. Analyses employed univariable and multivariable regression. Analysis was conducted for all patient problems/diagnoses, then for an 'at-risk' population (specific problems/diagnoses for which ACVRa is indicated).</p><p><strong>Setting: </strong>Three GP regional training organisations (RTOs) across three Australian states.</p><p><strong>Participants: </strong>GP registrars training within participating RTOs.</p><p><strong>Results: </strong>1003 registrars (response rate 96.8%) recorded details of 69 105 problems either with Aboriginal and/or Torres Strait patients aged 35 years and older or with non-Indigenous patients aged 45 years and older. Of these problems/diagnoses, 1721 (2.5% (95% CI 2.4% to 2.6%)) involved an ACVRa. An ACVRa was 'plausibly indicated' in 10 384 problems/diagnoses. Of these, 1228 (11.8% (95% CI 11.2% to 12.4%)) involved ACVRa. For 'all problems/diagnoses', on multivariable analysis female gender was associated with reduced odds of ACVRa (OR 0.61 (95% CI 0.54 to 0.68)). There was some evidence for Aboriginal and/or Torres Strait Islander people being more likely to receive ACVRa (OR 1.40 (95% CI 0.94 to 2.08), p=0.10). There were associations with variables related to continuity of care, with reduced odds of ACVRa: if the patient was new to the registrar (OR 0.65 (95% CI 0.57 to 0.75)), new to the practice (OR 0.24 (95% CI 0.15 to 0.38)) or the problem was new (OR 0.68 (95% CI 0.59 to 0.78)); and increased odds if personal follow-up was organised (OR 1.43 (95% CI 1.24 to 1.66)). For 'ACVRa indicated' problems/diagnoses, findings were similar to those for 'all problems/diagnoses'. Association with Aboriginal and/or Torres Strait Islander status, however, was significant at p<0.05 (OR 1.60 (95% CI 1.04 to 2.46)) and association with female gender was attenuated (OR 0.88 (95% CI 0.77 to 1.01)).</p><p><strong>Conclusion: </strong>Continuity of care is associated with registrars assessing ACVR, reinforcing the importance of care continuity in general practice. Registrars' assessment of an individual patient's ACVR is targeted to patients with individual risk factors, but this may entail ACVRa underutilisation in female patients and younger age groups.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"11 3","pages":""},"PeriodicalIF":6.1,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ed/82/fmch-2023-002251.PMC10445344.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10115691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glycaemic monitoring and control among high-risk patients with type 2 diabetes in Australian general practice during COVID-19.","authors":"Kirrilee Jane Barlow, Paul P Fahey, Evan Atlantis","doi":"10.1136/fmch-2023-002271","DOIUrl":"10.1136/fmch-2023-002271","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic disrupted general practice worldwide, primarily due to public health measures that restricted access to care for chronic diseases, such as type 2 diabetes. These measures disproportionately affected higher risk groups with type 2 diabetes, such as older people and those with obesity. This study aims to identify factors that may have influenced the rates of compliance with testing guidelines and target glycaemic control in Australian general practice settings during the COVID-19 pandemic.</p><p><strong>Methods: </strong>We used a serial cross-sectional study design of patient record data from general practices representative of the Nepean Blue Mountains Local Health District between 2020 and 2022. Aggregated patient records were analysed to determine percentages of subgroups with a blood glycaemic testing interval consistent with guidelines (≥1 within 15 months) and achieving target glycaemic control (by glycated haemoglobin of ≤7%). Linear regression models were used to test the association between independent and dependent variables, and to generate regression coefficients and 95% CI, corrected for time trends.</p><p><strong>Results: </strong>Of the average 14 356 patient records per month, 55% were male, 53% had a body mass index (BMI) <30 and 55% were aged 55-74 years. Compliance to testing guidelines slightly decreased (75-73%) but was positively associated with male sex (2.5%, 95% CI 1.7%, 3.4%), BMI≥30 (9.6%, 95% CI 8.8%, 10.4%) and 55-74 years (7.5%, 95% CI 6.6%, 8.5%) and 75 years and over age groups (7.1%, 95% CI 6.2%, 7.9%). Mean percentage of patient records achieving target glycaemic control slightly increased and was negatively associated with male sex (-3.7%, 95% CI -5.2%, -2.2%), but positively associated with 55-74 years (4.5%, 95% CI 3.8%, 5.1%) and 75 years and over age groups (12.2%, 95% CI 4.5%, 20.0%). Compliance to testing guidelines increased with each additional general practice per 10 000 persons (8.4%, 95% CI 4.9%, 11.8%).</p><p><strong>Conclusions: </strong>During the COVID-19 pandemic, people with type 2 diabetes in Australia continued to follow glycaemic testing guidelines at the same rate. In fact, there was a slight improvement in glycaemic control among all subgroups of patients, including those at higher risk. These findings are encouraging, but the longer term impact of COVID-19 on type 2 diabetes care is still unclear.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"11 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/51/c1/fmch-2023-002271.PMC10423797.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10108878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}