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PEACH: Patient Engagement And Coaching for Health an intensive intervention for patients with Type 2 Diabetes. Doris Young, John Furler, Christine Walker, Margarite Vale, James Best, Leonie Segal, Trisha Dunning (NHMRC GP clinical research grant July 2005-8). Background.

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  1. PEACH: Patient Engagement And Coaching for Health an intensive intervention for patients with Type 2 Diabetes Doris Young, John Furler, Christine Walker, Margarite Vale, James Best, Leonie Segal, Trisha Dunning (NHMRC GP clinical research grant July 2005-8)

  2. Background • Treatment gap worse for disadvantaged communities, less likely to see GPs and specialists, lower rates of lipid testing • Good evidence from clinical trials that intensive treatment interventions reduce biological risk factors and reduce morbidity/mortality * • (*Gaede et al. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes: N.Engl J Med. 2003; 348: 383-93)

  3. Hypothesis • Supporting patients with poorly controlled T2D through individual coaching by existing practice nurses in GP clinics will improve process of care and health outcomes compared with usual GP care and this approach will be cost effective

  4. Aim • To determine the effectiveness of a patient focused method for chronic disease self management (COACH program) in order to achieve intensive treatment goals for T2D in a GP setting

  5. PEACH study flowchart Generate list of up to 40 eligible patients from each Practice • Inclusion Criteria • Type 2 diabetes patients >18yrs • HbA1c>7.5% • Exclusion Criteria • No phone number • Other complex debilitating medical condition Mail out from Practices Optional follow-up phone calls by PN Second mail out from Practices • Appointment with PN • Explain study • Obtain consent • Baseline data collection Recruit eligible participants Randomise Practices Intervention Usual GP care + COACH program Control Usual GP care Follow-up assessments at 12 and 18 months

  6. Primary Outcome • Change in HbA1c level from baseline to 12 and 18 months post-randomisation in the intervention group compared with the control group

  7. BP, BMI, waist Smoking cessation (urinary cotinine at 18 months) Diabetes self efficacy Quality of Life (AQOL) Depression screening Hospitalisation and health service utilisation Process of GP care, blood tests Diabetes, anti-HT,statin, aspirin TC, TG, LDL, HDL Urinary albumin Physical activity and Diet Secondary Outcomes

  8. What’s in it for the practice? • Training the PN to identify diabetes patient population • Reimbursement for PN participation • Chance to access free diabetes education for the PN • COACH training for those involved in the intervention group • Paid 2 hr briefing session

  9. What’s in it for the PN? • Increased knowledge of diabetes • Expand your role • Expand your research skills • Certificate pf participation • CPD points • Free COACH training in the intervention group • Free COACH training to all if it proves successful

  10. What’s in it for the GP? • Improving care and health outcomes • Support in care planning and annual cycles of care • QA&CPD points • Detailed feedback on patients • Research training for interested GP’s

  11. Contact • Dr Irene Blackberry • 03 8344 3373 • i.blackberry@unimelb.edu.au • Thank You

  12. PEACH: Patient Engagement And Coaching for Health an intensive intervention for patients with Type 2 Diabetes Prof Doris Young, Principal Investigator, Dept of GP, The University of Melbourne, 200 Berkeley St, Carlton VIC 3053 Email: d.young@unimelb.edu.au www.peach.unimelb.edu.au

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