Washington [US], June 15: A new study by University of Virginia School of Medicine researchers and their collaborators found that patients with diabetes who participate in a free Annual Wellness Visit covered by Medicare are 36 per cent less likely to need an amputation.
The data has been taken into notice from 2006 to 2015 and the researchers analyzed that from 2006 patients with Medicare in the "Diabetes Belt.
Thus, 644 counties in the southeastern and Appalachian regions of the U.S. are with higher rates of diabetes. The Diabetes Belt includes the state of Mississippi as well as portions of Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia and West Virginia.
Patients living in the Diabetes Belt had 27 per cent greater odds of requiring a lower-extremity amputation compared to residents of counties surrounding the belt.
The researchers also found that, the odds of amputation were 36 per cent lower for patients that used their free Annual Wellness Visit that year compared to those who did not attend an Annual Wellness Visit regardless of where they lived.
A researcher in UVA’s department of Public Health Sciences, Jennifer Lobo said, "Our results confirmed our hypothesis that Annual Wellness Visits are associated with a reduced risk of major lower-extremity amputations, highlighting the importance of connecting patients to preventive care services."
People with diabetes are at higher risk for serious health complications, including blindness, kidney failure, stroke and heart disease, as well as the loss of toes, feet or legs.
Patients with diabetes who participated in their Annual Wellness Visit may have had their foot complications diagnosed sooner, helping prevent amputations, the researchers believe.
Patients using their Annual Wellness visits may also be more engaged in their care, may have less risk for more serious complications. Policymakers should prioritize incentives for patients with Medicare to use their annual wellness visits, the researchers conclude, to help reduce diabetes-related amputations.
The researchers also found significantly higher rates of diabetes-related amputations among non-Hispanic Black patients compared with non-Hispanic White patients both inside and outside the Diabetes Belt. The researchers recommend additional resources or policy changes - such as increased diabetes education or the use of patient navigators that help guide patients through the healthcare system - to address systemic barriers that are preventing non-Hispanic Black patients with diabetes from accessing the preventive care they need to prevent amputations.
"While Annual Wellness visits are a free visit for qualified Medicare beneficiaries, additional incentives or resources to overcome systemic access to care barriers are needed to support patient attendance," Lobo said. "Patient education about the value of Annual Wellness Visits and preventive care could also help improve utilization of Annual Wellness Visits, hopefully reducing the rate of major amputations."