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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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Relationship of AUSDRISK and random blood glucose test measures using median linear regression.
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Fig3: Relationship of AUSDRISK and random blood glucose test measures using median linear regression.

Mentions: Of the participants who undertook both measures, 33% had both high RBGT and high AUSDRISK; 20% normal RBGT and high AUSDRISK; 22% high RBGT and low AUSDRISK; 26% normal RBGT and low AUSDRISK. Using median linear regression with bootstrapping (Figure 3) adjusting for age and gender we showed that 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). Using AUSDRISK as the reference standard the sensitivity and specificity of the RBGT test was low (Table 3). The AUSDRISK score was less specific for age group (55+ years).Figure 3


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)

Relationship of AUSDRISK and random blood glucose test measures using median linear regression.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Fig3: Relationship of AUSDRISK and random blood glucose test measures using median linear regression.
Mentions: Of the participants who undertook both measures, 33% had both high RBGT and high AUSDRISK; 20% normal RBGT and high AUSDRISK; 22% high RBGT and low AUSDRISK; 26% normal RBGT and low AUSDRISK. Using median linear regression with bootstrapping (Figure 3) adjusting for age and gender we showed that 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). Using AUSDRISK as the reference standard the sensitivity and specificity of the RBGT test was low (Table 3). The AUSDRISK score was less specific for age group (55+ years).Figure 3

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