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Article: Microalbuminuria screening for patients having type 2 diabetes mellitus: Who wants to participate?

TitleMicroalbuminuria screening for patients having type 2 diabetes mellitus: Who wants to participate?
Authors
Issue Date2001
PublisherCanadian Medical Association. The Journal's web site is located at http://www.csci-scrc.medical.org/english/cim.html
Citation
Clinical And Investigative Medicine, 2001, v. 24 n. 1, p. 37-43 How to Cite?
AbstractBackground and objectives: "Difficult-to-recruit" patients are sometimes less compliant with their care, are more reluctant to seek medical attention and less likely to survive than their "easy-to-recruit" counterparts. They also tend to be excluded from clinical trials. The aim of this paper was to evaluate whether such differences extend to patients' willingness to be screened for diabetic nephropathy in a family practice setting. Design: A cross-sectional study. Setting: A Canadian university family practice unit. Patients: Two hundred and forty-seven patients with type 2 (adult-onset) diabetes mellitus as identified by computer searches of patient records of approximately 12 000 patients in the family practice unit. Intervention: A cross-sectional secondary preventive screening program obtained urine samples from all patients with type 2 diabetes mellitus, regardless of patients' willingness to participate. Main outcome measure: The prevalence of micro- and macroalbuminuria. Results: Of the 247 patients identified, 186 (75%) easy-to-recruit enrollees agreed to participate in screening and 61 (25%) difficult-to-recruit non-enrollees initially declined to be screened. The non-enrollees were subsequently evaluated by their own family physicians as part of routine clinical care and the results were captured for analysis. Overall rates of albuminuria were similar in the easy- and difficult-to-recruit groups (31% versus 38%, p = 0.151). The main predictors of albuminuria were female sex (odds ratio [OR] = 2.1, p = 0.021), duration of diabetes in years (OR = 1.05, p = 0.023), current use of angiotensin-converting enzyme inhibitor (OR = 2.26, p = 0.008) and number of diabetic complications (OR = 1.45, p = 0.028). Conclusions: There is little difference in the prevalence of albuminuria related to patients' willingness to participate in a screening program. Therefore, there are no disproportionate gains for family practice researchers who aggressively seek difficult-to-recruit patients in this setting. In contrast, primary care doctors should make every effort to ensure optimal care to diabetic patients regardless of a patient's initial hesitancy.
Persistent Identifierhttp://hdl.handle.net/10722/86461
ISSN
2015 Impact Factor: 1.191
2015 SCImago Journal Rankings: 0.502
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLeung, GMen_HK
dc.contributor.authorRedelmeier, DAen_HK
dc.contributor.authorSzalai, JPen_HK
dc.contributor.authorBoyle, Een_HK
dc.contributor.authorHilditch, JRen_HK
dc.contributor.authorTobe, SWen_HK
dc.date.accessioned2010-09-06T09:17:19Z-
dc.date.available2010-09-06T09:17:19Z-
dc.date.issued2001en_HK
dc.identifier.citationClinical And Investigative Medicine, 2001, v. 24 n. 1, p. 37-43en_HK
dc.identifier.issn0147-958Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/86461-
dc.description.abstractBackground and objectives: "Difficult-to-recruit" patients are sometimes less compliant with their care, are more reluctant to seek medical attention and less likely to survive than their "easy-to-recruit" counterparts. They also tend to be excluded from clinical trials. The aim of this paper was to evaluate whether such differences extend to patients' willingness to be screened for diabetic nephropathy in a family practice setting. Design: A cross-sectional study. Setting: A Canadian university family practice unit. Patients: Two hundred and forty-seven patients with type 2 (adult-onset) diabetes mellitus as identified by computer searches of patient records of approximately 12 000 patients in the family practice unit. Intervention: A cross-sectional secondary preventive screening program obtained urine samples from all patients with type 2 diabetes mellitus, regardless of patients' willingness to participate. Main outcome measure: The prevalence of micro- and macroalbuminuria. Results: Of the 247 patients identified, 186 (75%) easy-to-recruit enrollees agreed to participate in screening and 61 (25%) difficult-to-recruit non-enrollees initially declined to be screened. The non-enrollees were subsequently evaluated by their own family physicians as part of routine clinical care and the results were captured for analysis. Overall rates of albuminuria were similar in the easy- and difficult-to-recruit groups (31% versus 38%, p = 0.151). The main predictors of albuminuria were female sex (odds ratio [OR] = 2.1, p = 0.021), duration of diabetes in years (OR = 1.05, p = 0.023), current use of angiotensin-converting enzyme inhibitor (OR = 2.26, p = 0.008) and number of diabetic complications (OR = 1.45, p = 0.028). Conclusions: There is little difference in the prevalence of albuminuria related to patients' willingness to participate in a screening program. Therefore, there are no disproportionate gains for family practice researchers who aggressively seek difficult-to-recruit patients in this setting. In contrast, primary care doctors should make every effort to ensure optimal care to diabetic patients regardless of a patient's initial hesitancy.en_HK
dc.languageengen_HK
dc.publisherCanadian Medical Association. The Journal's web site is located at http://www.csci-scrc.medical.org/english/cim.htmlen_HK
dc.relation.ispartofClinical and Investigative Medicineen_HK
dc.subject.meshAgeden_HK
dc.subject.meshAlbuminuria - epidemiology - urineen_HK
dc.subject.meshAngiotensin-Converting Enzyme Inhibitors - therapeutic useen_HK
dc.subject.meshCross-Sectional Studiesen_HK
dc.subject.meshDiabetes Mellitus, Type 2 - complications - urineen_HK
dc.subject.meshDiabetic Nephropathies - prevention & control - urineen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHemoglobin A, Glycosylated - analysisen_HK
dc.subject.meshHumansen_HK
dc.subject.meshHypertension - drug therapy - urineen_HK
dc.subject.meshLogistic Modelsen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshPatient Complianceen_HK
dc.subject.meshSex Characteristicsen_HK
dc.subject.meshTime Factorsen_HK
dc.titleMicroalbuminuria screening for patients having type 2 diabetes mellitus: Who wants to participate?en_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0147-958X&volume=24&spage=37&epage=43&date=2001&atitle=Microalbuminuria+screening+for+patients+having+type+2+diabetes+mellitus:+Who+wants+to+participate?en_HK
dc.identifier.emailLeung, GM:gmleung@hku.hken_HK
dc.identifier.authorityLeung, GM=rp00460en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid11266030-
dc.identifier.scopuseid_2-s2.0-0035105490en_HK
dc.identifier.hkuros56368en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0035105490&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume24en_HK
dc.identifier.issue1en_HK
dc.identifier.spage37en_HK
dc.identifier.epage43en_HK
dc.identifier.isiWOS:000167330700003-
dc.publisher.placeCanadaen_HK
dc.identifier.scopusauthoridLeung, GM=7007159841en_HK
dc.identifier.scopusauthoridRedelmeier, DA=7006152371en_HK
dc.identifier.scopusauthoridSzalai, JP=7004854958en_HK
dc.identifier.scopusauthoridBoyle, E=23476400900en_HK
dc.identifier.scopusauthoridHilditch, JR=6701392831en_HK
dc.identifier.scopusauthoridTobe, SW=7102112089en_HK

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