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

• Published in: Diabetes research and clinical practice Vol. 75; no. 3; pp. 339 - 347
• Main Authors: Krass, I., Mitchell, B., Clarke, P., Brillant, M., Dienaar, R., Hughes, J., Lau, P., Peterson, G., Stewart, K., Taylor, S., Wilkinson, J., Armour, C.
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.03.2007
• Subjects: Australia - epidemiology; Blood Glucose - analysis; Case detection; Community pharmacy; Cost-effectiveness; Diabetes Mellitus, Type 2 - epidemiology; Endocrinology & Metabolism; Heart Diseases - epidemiology; Humans; Hypertension - epidemiology; Mass Screening - methods; Middle Aged; Near patient testing; Pharmacies - standards; Reference Values; Referral and Consultation; Risk Factors; Type 2 diabetes; Australia; Type 2 diabetes; Case detection; Cost-effectiveness; Near patient testing; Community pharmacy
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/j.diabres.2006.06.022

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