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Comparison of two methods for assessing diabetes risk in a pharmacy setting in Australia.

Kilkenny MF, Johnson R, Andrew NE, Purvis T, Hicks A, Colagiuri S, Cadilhac DA - BMC Public Health (2014)

Bottom Line: Among participants who undertook both measures, 32% recorded a high RBGT and high AUSDRISK.There was a significant association between RBGT and AUSDRISK scores.For every one point increase in AUSDRISK score there was a half point increase in RBGT levels (coefficient 0.55, 95% CI: 0.28, 0.83).

View Article: PubMed Central - PubMed

Affiliation: Stroke and Ageing Research School of Clinical Sciences at Monash Health, Monash University, Level 1/43-51 Kanooka Grove, Clayton, 3168 Melbourne, VIC, Australia. monique.kilkenny@monash.edu.

ABSTRACT

Background: Since 2007, the Australian Know your numbers (KYN) program has been used in community settings to raise awareness about blood pressure and stroke. In 2011, the program was modified to include assessment for type 2 diabetes risk. However, it is unclear which approach for assessing diabetes risk in pharmacies is best. We compared two methods: random (non-fasting) blood glucose testing (RBGT); and the Australian type 2 diabetes risk assessment tool (AUSDRISK); according to 1) identification of 'high risk' participants including head-to-head sensitivity and specificity; 2) number of referrals to doctors; and 3) feasibility of implementation.

Methods: 117 Queensland pharmacies voluntarily participated and were randomly allocated to RBGT and AUSDRISK or AUSDRISK only. Although discouraged, pharmacies were able to change allocated group prior to commencement. AUSDRISK is a validated self-administered questionnaire used to calculate a score that determines the 5-year risk of developing type 2 diabetes. AUSDRISK (score 12+) or RBGT (≥5.6 mmol/I) indicates a high potential risk of diabetes. Median linear regression was used to compare the two measures. Staff from 68 pharmacies also participated in a semi-structured interview during a site visit to provide feedback.

Results: Data were submitted for 5,483 KYN participants (60% female, 66% aged >55 years, 10% history of diabetes). Approximately half of the participants without existing diabetes were identified as 'high risk' based on either RBGT or AUSDRISK score. Among participants who undertook both measures, 32% recorded a high RBGT and high AUSDRISK. There was a significant association between RBGT and AUSDRISK scores. For every one point increase in AUSDRISK score there was a half point increase in RBGT levels (coefficient 0.55, 95% CI: 0.28, 0.83). Pharmacy staff reported that AUSDRISK was a simple, low cost and efficient method of assessing diabetes risk compared with RBGT, e.g. since management of sharps is not an issue.

Conclusions: In a large, community-based sample of Australians about half of the participants without diabetes were at 'high risk 'of developing diabetes based on either AUSDRISK or RBGT results. AUSDRISK was considered to be an acceptable method for assessing the risk of diabetes using opportunistic health checks in community pharmacies.

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Related in: MedlinePlus

Recruitment of pharmacies and participants who registered in KYN diabetes program. *Pharmacies were given 2-3 weeks to change groups if they considered their allocation was not suitable **Ineligible includes people who reported having a history of diabetes. Permanent means pharmacy with year-long KYN Program; KYN: Know your numbers Program; RBGT: Random blood glucose testing; AUSDRISK: Australian Type 2 Diabetes Risk Assessment Tool.
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Fig1: Recruitment of pharmacies and participants who registered in KYN diabetes program. *Pharmacies were given 2-3 weeks to change groups if they considered their allocation was not suitable **Ineligible includes people who reported having a history of diabetes. Permanent means pharmacy with year-long KYN Program; KYN: Know your numbers Program; RBGT: Random blood glucose testing; AUSDRISK: Australian Type 2 Diabetes Risk Assessment Tool.

Mentions: The Queensland KYN program delivered in community pharmacies was modified in 2011 to include a free diabetes risk assessment and educational information for participants. A sample of KYN pharmacies in Queensland agreed to participate in the pilot study (Figure 1). These pharmacies offered the KYN program all year round on a permanent basis. The pharmacies were initially randomly allocated to provide one or two diabetes risk assessment measures in addition to a BP measurement (Figure 1). However, this was a pragmatic and voluntary study and pharmacies, although discouraged from doing so, were able to change their allocated group prior to commencement. Therefore, the study was observational and aimed to compare the two methods proposed for assessing diabetes risk as part of KYN in a pharmacy setting in Australia. The Group 1 pharmacies provided BP testing, RBGT and AUSDRISK. The Group 2 pharmacies provided BP testing and AUSDRISK only.Figure 1


Comparison of two methods for assessing diabetes risk in a pharmacy setting in Australia.

Kilkenny MF, Johnson R, Andrew NE, Purvis T, Hicks A, Colagiuri S, Cadilhac DA - BMC Public Health (2014)

Recruitment of pharmacies and participants who registered in KYN diabetes program. *Pharmacies were given 2-3 weeks to change groups if they considered their allocation was not suitable **Ineligible includes people who reported having a history of diabetes. Permanent means pharmacy with year-long KYN Program; KYN: Know your numbers Program; RBGT: Random blood glucose testing; AUSDRISK: Australian Type 2 Diabetes Risk Assessment Tool.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4289299&req=5

Fig1: Recruitment of pharmacies and participants who registered in KYN diabetes program. *Pharmacies were given 2-3 weeks to change groups if they considered their allocation was not suitable **Ineligible includes people who reported having a history of diabetes. Permanent means pharmacy with year-long KYN Program; KYN: Know your numbers Program; RBGT: Random blood glucose testing; AUSDRISK: Australian Type 2 Diabetes Risk Assessment Tool.
Mentions: The Queensland KYN program delivered in community pharmacies was modified in 2011 to include a free diabetes risk assessment and educational information for participants. A sample of KYN pharmacies in Queensland agreed to participate in the pilot study (Figure 1). These pharmacies offered the KYN program all year round on a permanent basis. The pharmacies were initially randomly allocated to provide one or two diabetes risk assessment measures in addition to a BP measurement (Figure 1). However, this was a pragmatic and voluntary study and pharmacies, although discouraged from doing so, were able to change their allocated group prior to commencement. Therefore, the study was observational and aimed to compare the two methods proposed for assessing diabetes risk as part of KYN in a pharmacy setting in Australia. The Group 1 pharmacies provided BP testing, RBGT and AUSDRISK. The Group 2 pharmacies provided BP testing and AUSDRISK only.Figure 1

Bottom Line: Among participants who undertook both measures, 32% recorded a high RBGT and high AUSDRISK.There was a significant association between RBGT and AUSDRISK scores.For every one point increase in AUSDRISK score there was a half point increase in RBGT levels (coefficient 0.55, 95% CI: 0.28, 0.83).

View Article: PubMed Central - PubMed

Affiliation: Stroke and Ageing Research School of Clinical Sciences at Monash Health, Monash University, Level 1/43-51 Kanooka Grove, Clayton, 3168 Melbourne, VIC, Australia. monique.kilkenny@monash.edu.

ABSTRACT

Background: Since 2007, the Australian Know your numbers (KYN) program has been used in community settings to raise awareness about blood pressure and stroke. In 2011, the program was modified to include assessment for type 2 diabetes risk. However, it is unclear which approach for assessing diabetes risk in pharmacies is best. We compared two methods: random (non-fasting) blood glucose testing (RBGT); and the Australian type 2 diabetes risk assessment tool (AUSDRISK); according to 1) identification of 'high risk' participants including head-to-head sensitivity and specificity; 2) number of referrals to doctors; and 3) feasibility of implementation.

Methods: 117 Queensland pharmacies voluntarily participated and were randomly allocated to RBGT and AUSDRISK or AUSDRISK only. Although discouraged, pharmacies were able to change allocated group prior to commencement. AUSDRISK is a validated self-administered questionnaire used to calculate a score that determines the 5-year risk of developing type 2 diabetes. AUSDRISK (score 12+) or RBGT (≥5.6 mmol/I) indicates a high potential risk of diabetes. Median linear regression was used to compare the two measures. Staff from 68 pharmacies also participated in a semi-structured interview during a site visit to provide feedback.

Results: Data were submitted for 5,483 KYN participants (60% female, 66% aged >55 years, 10% history of diabetes). Approximately half of the participants without existing diabetes were identified as 'high risk' based on either RBGT or AUSDRISK score. Among participants who undertook both measures, 32% recorded a high RBGT and high AUSDRISK. There was a significant association between RBGT and AUSDRISK scores. For every one point increase in AUSDRISK score there was a half point increase in RBGT levels (coefficient 0.55, 95% CI: 0.28, 0.83). Pharmacy staff reported that AUSDRISK was a simple, low cost and efficient method of assessing diabetes risk compared with RBGT, e.g. since management of sharps is not an issue.

Conclusions: In a large, community-based sample of Australians about half of the participants without diabetes were at 'high risk 'of developing diabetes based on either AUSDRISK or RBGT results. AUSDRISK was considered to be an acceptable method for assessing the risk of diabetes using opportunistic health checks in community pharmacies.

Show MeSH
Related in: MedlinePlus