Abstract
Aims
To compare the effectiveness of three pharmacy-based screening methods for type 2
diabetes (T2DM): (1) risk assessment (AUSDRISK) alone (Group A); AUSDRISK followed
by a point of care test if AUSDRISK ≥12; either (2) HbA1c (Group B); or (3) small
capillary blood glucose test (Group C).
Methods
A cluster RCT with a nationally representative sample of Australian pharmacies was
implemented with random allocation of eligible pharmacies to Groups A, B or C. GP
referral was based on prespecified cut offs. Diagnoses were considered positive if
confirmed by a GP, pathology laboratory, or national diabetes register.
Results
Of the 14,093 people screened in 339 pharmacies, 3059 participants met group-specific
referral criteria: 1775 (45%) (Group A); 893 (17%) (Group B); and 391 (8%) (Group
C). For the total screened population rates of T2DM diagnoses were significantly higher
in Group B (1.5%), compared with Groups A (< 0.8%) and C (< 0.6%) with the odds of
detection in Group B compared with Group A (1.8 [1.0;3.0]), and no difference between
Groups A and C.
Conclusions
In community pharmacy, the most effective method to uncover undiagnosed T2DM was a
stepwise approach; initial risk assessment; and if appropriate an HbA1C POC test and
referral.
Keywords
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Article info
Publication history
Published online: February 02, 2023
Accepted:
January 30,
2023
Received in revised form:
November 4,
2022
Received:
January 27,
2022
Identification
Copyright
© 2023 Elsevier B.V. All rights reserved.
