HbA1c testing at proper frequencies does not depict appropriate changes in treatment

According to a study conducted by a researcher at Emory University in Atlanta, fewer than one out of five patients were tested for HbA1c at the recommended frequency. And even when testing frequency recommendations were met and a significant increase in reference change value was observed, treatment changes were made less than one-third of the time.

The study, presented at ASCP, held in September in Chicago, assessed clinician practice by monitoring HbA1c testing and medical chart review with clinician survey to determine whether treatment changes are made based on calculated HbA1c reference change values. HbA1c values (N=32,112) over a one-year period were extracted from the laboratory information system and the data filtered and partitioned to include only patients who were tested at least twice within the time frame of the study at the recommended frequency.

The chart review and clinician survey was conducted to assess treatment changes for patients whose initial HbA1c demonstrated glycemic control but subsequent HbA1c testing at the recommended frequency did not. The testing frequency observed suggests only ~17% (n=737) of patients were being tested at the recommended frequency. The data also indicates that when HbA1c testing frequency recommendations are met, treatment changes were made only 30% (n=23) of the time even when the HbA1c represented a significant increase.