Pharmacy diabetes care program: Analysis of two screening methods for undiagnosed type 2 diabetes in Australian community pharmacy

Krass, I.; Mitchell, B.; Clarke, P.; Brillant, M.; Dienaar, R.; Hughes, J.; Lau, P.; Peterson, G.; Stewart, K.; Taylor, S.; Wilkinson, J.; Armour, C.

doi:10.1016/j.diabres.2006.06.022

« Previous Next »Diabetes Research and Clinical Practice
Volume 75, Issue 3 , Pages 339-347, March 2007

Pharmacy diabetes care program: Analysis of two screening methods for undiagnosed type 2 diabetes in Australian community pharmacy

I. Krass
- Faculty of Pharmacy, Sydney University, NSW 2006, Australia
- Corresponding author. Tel.: +61 2 9351 3507; fax: +61 2 9351 4451.
B. Mitchell
- Faculty of Pharmacy, Sydney University, NSW 2006, Australia
P. Clarke
- School of Public Health, University of Sydney, Australia
M. Brillant
- Faculty of Pharmacy, Sydney University, NSW 2006, Australia
R. Dienaar
- Tasmanian School of Pharmacy, University of Tasmania, Australia
J. Hughes
- School of Pharmacy, Curtin University, Australia
P. Lau
- Victorian College of Pharmacy, Monash University, Australia
G. Peterson
- Tasmanian School of Pharmacy, University of Tasmania, Australia
K. Stewart
- Victorian College of Pharmacy, Monash University, Australia
S. Taylor
- Faculty of Pharmacy, Sydney University, NSW 2006, Australia
J. Wilkinson
- School of Pharmacy, Curtin University, Australia
C. Armour
- Faculty of Pharmacy, Sydney University, NSW 2006, Australia

Received 24 April 2006; accepted 22 June 2006. published online 10 August 2006.

Abstract

Objective

To compare the efficacy and cost-effectiveness of two methods of screening for undiagnosed type 2 diabetes in Australian community pharmacy.

Methods

A random sample of 30 pharmacies were allocated into two groups: (i) tick test only (TTO); or (ii) sequential screening (SS) method. Both methods used the same initial risk assessment for type 2 diabetes. Subjects with one or more risk factors in the TTO group were offered a referral to their general practitioner (GP). Under the SS method, patients with risk factors were offered a capillary blood glucose test and those identified as being at risk referred to a GP. The effectiveness and cost-effectiveness of these approaches was assessed.

Results

A total of 1286 people were screened over a period of 3 months. The rate of diagnosis of diabetes was significantly higher for SS compared with the TTO method (1.7% versus 0.2%; p=0.008). The SS method resulted in fewer referrals to the GP and a higher uptake of referrals than the TTO method and so was the more cost-effective screening method.

Conclusions

SS is the superior method from a cost and efficacy perspective. It should be considered as the preferred option for screening by community based pharmacists in Australia.

Keywords: Near patient testing, Case detection, Type 2 diabetes, Community pharmacy, Cost-effectiveness