OBJECTIVES : Frequency of HbA1c testing is associated with type 2 diabetes (T2D) management and control, but limited data exists on the relationship between HbA1c testing and patient-reported measures such as HRQoL. This study used patient-reported survey data linked with laboratory tests from electronic health records (EHR) to assess differences in HRQoL associated with HbA1c testing frequency.

METHODS : Patient-Centered-Research (PaCeR) US data (2015-2018; N=345,184), consisting of nationally-representative patient-reported survey data, were linked with a large US ambulatory EHR database (2015-2018; N=50 million+) in a HIPAA-compliant linking methodology. The study population consisted of linked respondents who were diagnosed with T2D and had at least one HbA1c test result in the EHR within six months of survey participation. Study participants were grouped by HbA1c testing frequency (1-2 tests/year, 3-4 tests/year, 5+ tests/year) and compared on sociodemographic and HRQoL measures using two-sample t-tests and chi-square tests. HRQoL measures included SF-36v2 (mental and physical component summary scores [MCS and PCS] and SF-6D health utility index).

RESULTS : Of 492 total T2D patients who met the study criteria [mean age = 61.3 years, 54.7% female, 85.6% White, 38.8% uncontrolled HbA1c (≥ 7%)], 58.1% had 1-2 HbA1c tests/year, 26.6% had 3-4 HbA1c tests/year, and 15.2% had 5+ HbA1c tests/year. T2D patients with 1-2 HbA1c tests/year had significantly lower MCS compared to those with 3-4 HbA1c tests/year (mean = 48.8 vs. 51.8, p = 0.01). Vitality (mean = 47.6 vs. 50.0, p = 0.04) and mental health (mean = 48.6 vs. 52.1, p < 0.005) domain scores were also lower among patients with 1-2 HbA1c tests/year compared to patients with 3-4 HbA1c tests/year. There were no differences in HRQoL between the 1-2 tests/year and 5+ tests/year groups.

CONCLUSIONS : Linking patient-reported outcomes with EHR data facilitated analysis of HbA1c testing with HRQoL. Results showed that less frequent HbA1c testing was associated with lower MCS.