Optimizing physician‐encounter frequency for type 2 diabetes patients in primary care based on cardiovascular risk assessment: A target trial emulation study
Authors' conclusion
For T2D patients with a calculated 10-year CVD risk of less than 20%, the interval of regular physician encounters can be optimized from 2-3 to 4-6 months without compromising patients' long-term outcomes and saving substantial service resources in primary care.
Study context
- Population
- T2D patients without prior cardiovascular disease (CVD) and with predicted 10-year CVD risk <20%, Hong Kong public primary care
- Participants
- 42,154 matched individuals
- Comparison
- Physician-encounter interval 4-6 months vs 2-3 months
- Outcome
- CVD incidence
- Follow-up
- Up to 12 (average: 5.1) years
Methodological detailspropensity-score matched, marginal structural model, territory-wide electronic medical records
- Propensity-score matched
- Marginal structural model
- Territory-wide electronic medical records
Main finding
As reported in the abstract
CVD · up to 12 (average: 5.1) years
Each group vs 2-3 monthsHazard ratio (95% CI)
4-6 months
1.01(0.90–1.14)
Each group vs 2-3 monthsStandardized 10-year risk difference (95% CI)
4-6 months
−0.1%(−0.7% to 0.6%)
Further findings
| Outcome | HR (CI) | |
|---|---|---|
| All-cause mortality4-6 monthsvs 2-3 months | 1.00 (0.84–1.20) | |
| 0.512Hazard ratio (log scale) |
| Outcome | Standardized 10-year risk difference (CI) | |
|---|---|---|
| All-cause mortality4-6 monthsvs 2-3 months | −0.1% (−0.5% to 0.3%) | |
| −0.6−0.4−0.200.20.4Difference (linear scale) |
Secondary and tertiary care utilization; key clinical parameters (HbA1c, blood pressure, cholesterol)
- No observable difference between the two follow-up frequencies
Original publication
Optimizing physician‐encounter frequency for type 2 diabetes patients in primary care based on cardiovascular risk assessment: A target trial emulation study. Diabetes Obes Metab. Published 29 August 2024. doi:10.
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