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Continuity of diabetes care among elderly Japanese patients: a medical record review study in a specialized diabetes clinic

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Abstract

Aims

Continuity of diabetes care is relevant among elderly patients. The aim of this study is to investigate the impact of clinical characteristics on continuing outpatient visits to a specialized diabetes clinic in elderly Japanese patients with diabetes.

Methods

We included outpatients with type 2 diabetes aged ≥ 65 years who first visited our clinic from 2006 to 2009. The information of patients’ characteristics was obtained through medical record review from the CoDiC database. We have tracked whether the patients continued to visit the clinic until May 31, 2019. A Cox proportional hazards regression model identified variables related to withdrawal.

Results

Among 128 patients, 63 patients (49.2%) were withdrawn during the follow-up periods. The average visit duration of withdrawals was 4.6 (range 1, 10) years. The patients who discontinued to visit were older (72.6 vs. 69.5 years old, p = 0.005) compared with those who continued to visit. No significant differences in clinical conditions such as complication of diabetes, Charlson Comorbidity Index and polypharmacy between the first and last visit were observed in each group. Age (≥ 75 years) was significantly associated with withdrawal (hazard ratio 2.72 [95% confidence interval 1.59, 4.63], p < 0.001). Except for age, no significant differences were observed in all variables when adjusted for confounders.

Conclusions

Our findings indicated that continuous outpatient visits were difficult in elderly Japanese patients with diabetes. Older age (≥ 75 years) independently affected withdrawal. Future multicenter studies with adequate populations and social and geriatric factors are necessary to confirm our findings.

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Acknowledgements

We would like to thank all the participants for their cooperation in our study. We are grateful to Dr. Kazuya Fujihara in Niigata University Faculty of Medicine for his advice on revision.

Funding

This study was supported by JSPS KAKENHI (Grant No. JP20K18871).

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Authors and Affiliations

  1. Kawai Clinic, 715-1 Higashi-Hiratsuka, Tsukuba, Ibaraki, 305-0812, Japan

    Rie Tanaka, Shinobu Motohashi, Junko Morioka, Akimitsu Takahashi, Katsuya Yamazaki & Koichi Kawai

  2. Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan

    Rie Tanaka

Authors
  1. Rie Tanaka
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  2. Shinobu Motohashi
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  3. Junko Morioka
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  4. Akimitsu Takahashi
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  5. Katsuya Yamazaki
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  6. Koichi Kawai
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Corresponding author

Correspondence to Rie Tanaka.

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The authors declare that there are no conflicts of interest.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1964 and later versions.

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Tanaka, R., Motohashi, S., Morioka, J. et al. Continuity of diabetes care among elderly Japanese patients: a medical record review study in a specialized diabetes clinic. Diabetol Int 13, 584–589 (2022). https://doi.org/10.1007/s13340-022-00569-y

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  • DOI: https://doi.org/10.1007/s13340-022-00569-y

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