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Patient recruitment for Diabetes Prevention Program (Study) & The Healthy Living Course 2006 Jill Kelly

Patient recruitment for Diabetes Prevention Program (Study) & The Healthy Living Course 2006 Jill Kelly. Delivering health solutions through general practice. GP Communication principles Usual care in general practice Recruitment strategies for DPP from General Practice

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Patient recruitment for Diabetes Prevention Program (Study) & The Healthy Living Course 2006 Jill Kelly

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  1. Patient recruitment for Diabetes Prevention Program (Study) & The Healthy Living Course 2006 Jill Kelly Delivering health solutions through general practice

  2. GP Communication principles • Usual care in general practice • Recruitment strategies for DPP from General Practice • Outcomes of interest

  3. GP Communication • GPs want: • to know what happens with their patients • to be consulted before further referrals are made to • other agencies/services • Fax, phone, letter • Keep it simple!

  4. Usual Care in General Practice • Annual Fasting Blood Glucose (FBG) is usual care • NHMRC guidelines advise use of OGTT • Real & perceived barriers to OGTT’s • Pathology companies’ range for pre-diabetes is • 6.0-6.9 mmol/L • Usual treatment includes Lifestyle advice and may • include referral for Diabetes Education

  5. Practice Marketing & Engagement • Clear information on research methodology, billing & pathology testing • Simplified patient identification, assessment & referral processes • Financial incentives • Research nurses to case-find • Use of electronic Statewide Referral Form • 24 practices engaged in 4 months

  6. Patient recruitment in General Practice • Case-finding from pathology results • Searching patient database by condition coding • Opportunistic patient identification • Practice Nurse role • Change in practice and systems Sustainability Referrals Easy Hard Hard Less hard

  7. What is Case Finding? • Pathology company list of patients with FBG or OGTT in “pre-diabetes” range or PEN tool • Review patient history for eligibility • Letter from practice to patient • Put “action” note in patient file • Resource intensive & not a sustainable strategy

  8. Electronic database searches • Electronic medical records • Searching for patients coded as IGT • Variety of software programs • GPs not required to code diagnosis • Reasonably successful strategy • PEN tool now available

  9. Practice Nurse role • Possible strategies: • undertake risk screening • population health approach utilsing IT/IM if skilled & • resourced • What we found: • PN often not decision-maker, therefore difficult • to engage

  10. Practice snapshots

  11. Clients completed Course 35 30 25 20 Male 15 Female 10 5 0 Under 45 46-55 years 56-65 years 66-80 years over 80 years years Clients enrolled

  12. Patient recruitment via General Practice 475 patients sent letters 153 responded to letters 3073 patients identified by pathology companies & database searches & assessed for inclusion criteria 103 total patients completed phase 1 89% of these from general practice Healthy Living course participants

  13. Changes in GP practice • Improved coding of pre-diabetes • Increased use of OGTT in pre-diabetes • Increased number of diabetics identified • Reviewing patients in 5.5-5.9 mmol/L range • GPs interested in preventive health research • Systems in general practice – always a challenge! • Anecdotal & observation

  14. Summary • LONG time for change in usual care…. • GPs want to see benefits to “real” patients in real-life • setting • Recording & coding are major IM issues • Resource intensive and range of strategies required • for patient recruitment

  15. Working with local LMP providers Jill Kelly

  16. Working with Primary Care Partnerships • Aims: • To minimise service fragmentation & ensure service system integration • To increase efficiency of referral pathways (for general practice)

  17. Who • Working group - Life providers (Community Health Services) and Division • Developed Memorandum of Understanding • Agreed protocols for in-take / assessment • Ensuring communication with Division and local GPs • Working group reports to PCP ICDM Steering Committee

  18. What can the Division do? • Providing advice on pathway for MBS 713 to Community Health Services & private Life! providers • Referral intake for GPs & distribution of referrals to Life providers • Marketing to GPs • Facilitating communication between Division & LMP’s

  19. Leadership • Good relationship with local providers (Community Health Services & private providers) • Trust • Communication

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