1637-P: Beliefs and Knowledge Shaping Primary Care Provider Referrals to the Medicare Diabetes Prevention Program: A Mixed Methods Study

Introduction and Objective: Prediabetes affects half of older adults, yet fewer than 1% have participated in the Medicare Diabetes Prevention Program (MDPP). Primary care providers (PCPs) are well positioned to increase MDPP uptake through patient referrals. To identify strategies to increase referrals, this mixed methods study examined PCP beliefs about managing prediabetes among older adults, including their knowledge of the MDPP. Methods: We administered the Healthcare Provider Prediabetes Survey to a national sample of 195 PCPs. We also conducted semi-structured interviews with 16 PCPs to further explore factors influencing MDPP referrals. Interviews were guided by the Consolidated Framework for Implementation Research, and interview data were analyzed using the Rapid Group Analysis process. Frequencies and proportions were calculated for Likert-scale survey data. Results: PCPs included physicians (n=92), nurse practitioners (n=50) and physician assistants (n=53). Most PCPs were White (76%) and female (62%). While 93% agreed that evidence supports the effectiveness of lifestyle modification for prediabetes, over half were unfamiliar with the MDPP, unaware of organizations offering the program, and/or unsure how to refer patients. Qualitative data aligned with survey results: PCPs viewed lifestyle change as the first-line treatment for prediabetes but were unaware of the MDPP and its availability at no cost to Medicare beneficiaries. Interviewees saw a strong need for the MDPP but did not know how or where to refer patients. PCPs recommended direct-to-consumer MDPP advertising and simplifying the referral and enrollment processes to improve uptake. Conclusion: Although PCPs strongly endorse lifestyle change for older adults with prediabetes, they are largely unaware of the MDPP. Targeted strategies are needed to increase provider awareness of this no-cost diabetes prevention program for Medicare beneficiaries. Disclosure M. Turk: None. N. Ritchie: None. B.T. Norton: None. A. Pushkarna: None. Funding National Institutes of Health (R15HL163736)