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Glycemic control for patients with PTSD: Primary care effects

Frayne S, Sharkansky EJ, Keane T, Rosen CS, Lin H, Halanych JH, Miller DR. Glycemic control for patients with PTSD: Primary care effects. Poster session presented at: International Society for Traumatic Stress Studies Annual Meeting; 2004 Nov 1; New Orleans, LA.

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Abstract:

Purpose: The poor physical health seen in patients with post-traumatic stress disorder (PTSD) could reflect, in part, their medical care. We examined whether diabetics with PTSD had worse glycemic control than those without mental health conditions (MHC), and whether frequent primary care visits had a protective effect. Methods: From all Veterans Health Administration outpatients with diabetes whose facility submitted 1999 lab data to a centralized registry, we used ICD9 codes to identify the 236,377 with no MHC and the 18,859 with PTSD. Using logistic regression and adjusting for demographics and comorbidities, stratified on receipt of primary care (0, 1-2, or 3+ visits), we compared glycemic control in patients with PTSD to those with no MHC. Findings: Adjusted odds ratios (95% CI) for poor glycemic control were 1.32 (1.15, 1.51), 1.22 (1.13, 1.32), and 1.18 (1.13, 1.23) in PTSD vs no MHC patients with 0, 1-2, and 3+ primary care visits, respectively. Conclusions: Diabetics with PTSD are more likely than those without MHC to have poor glycemic control, but the likelihood decreases with increasing number of primary care visits. Systems-level interventions, such as coordination of mental health and primary care efforts, may improve care for PTSD patients with comorbid medical conditions.





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