Current attitudes of primary care providers toward albuminuria testing in patients with diabetes in the United States.

OBJECTIVE

To evaluate primary care providers' attitudes and practices regarding albuminuria testing in patients with type 2 diabetes in the United States.

METHODS

Using a web-based opt-in panel of providers (Porter Novelli DocStyles survey, Fall 2024), we conducted a cross-sectional study to assess attitudes toward albuminuria testing, adherence to guidelines, and reported barriers. Associations were estimated using multivariable Poisson regression.

RESULTS

Among 1236 providers who see at least one patient with diabetes weekly, 90.0% supported albuminuria testing and 83.3% agreed that annual testing helps with diabetes prognosis. Adherence to recommended urine testing-defined as correct test type, concurrent urine creatinine measurement, and recommended testing frequency-ranged from 52% to 68%. Lower adherence was associated with inpatient practice, being a nurse practitioner or physician assistant, lack of a urinalysis reminder system, perceived guideline ambiguity or time constraints, and lower diabetes patient volume.

CONCLUSIONS

Despite most providers supporting urine testing for patients with diabetes, significant gaps between knowledge and practice were identified. Clinical decision support tools and clearer recommendations may help close the gaps between the guideline recommendations and practice.