Abstract
Objective: To indicate levels of monitoring of type 2 diabetes in rural and regional Australia by examining patterns of glycated haemoglobin (HbA1c) and blood lipid testing. Design and Setting: Retrospective analysis of pathology services data from twenty regional and rural towns in eastern Australia over 24 months. Participants: Of 13 105 individuals who had either a single HbA1c result ≥7.0% (53 mmol mol−1); or two or more HbA1c tests within the study period. Main outcome measures: Frequency of testing of HbA1c and blood lipids (cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol and triglycerides) were compared with guideline recommendations. Results: About 58.3% of patients did not have the recommended 6-monthly HbA1c tests and 30.6% did not have annual lipid testing. For those who did not receive tests at the recommended interval, the mean between-test interval was 10.5 months (95% CI = 7.5–13.5) rather than 6 months for HbA1c testing; and 15.7 (95% CI = 13.3–18.1) months rather than annually for blood lipids. For those with at least one out-of-range test result, 77% of patients failed to receive a follow-up HbA1c test and 86.5% failed to receive a follow-up blood lipid test within the recommended 3 months. Patients less than 50 years of age, living in a more remote area and with poor diabetes control were less likely to have testing at the recommended intervals (P < 0.0001). Conclusions: Although poor diabetes testing is not limited to rural areas, more intensive diabetes monitoring is likely to be needed for patients living in non-metropolitan areas, particularly for some subgroups.
| Original language | English |
|---|---|
| Pages (from-to) | 371-377 |
| Number of pages | 7 |
| Journal | Australian Journal of Rural Health |
| Volume | 24 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 1 Dec 2016 |
Keywords
- diabetes mellitus
- HbA1c
- patient care management
- rural health
- vulnerable populations
Cite this
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Patterns of type 2 diabetes monitoring in rural towns : How does frequency of HbA1c and lipid testing compare with existing guidelines? / Paul, Christine Louise; Piterman, Leon; Shaw, Jonathan E.; Kirby, Catherine; Barker, Daniel; Robinson, Jennifer; Forshaw, Kristy L.; Sikaris, Kenneth A.; Bisquera, Alessandra; Sanson-Fisher, Robert W.
In: Australian Journal of Rural Health, Vol. 24, No. 6, 01.12.2016, p. 371-377.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Patterns of type 2 diabetes monitoring in rural towns
T2 - How does frequency of HbA1c and lipid testing compare with existing guidelines?
AU - Paul, Christine Louise
AU - Piterman, Leon
AU - Shaw, Jonathan E.
AU - Kirby, Catherine
AU - Barker, Daniel
AU - Robinson, Jennifer
AU - Forshaw, Kristy L.
AU - Sikaris, Kenneth A.
AU - Bisquera, Alessandra
AU - Sanson-Fisher, Robert W.
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Objective: To indicate levels of monitoring of type 2 diabetes in rural and regional Australia by examining patterns of glycated haemoglobin (HbA1c) and blood lipid testing. Design and Setting: Retrospective analysis of pathology services data from twenty regional and rural towns in eastern Australia over 24 months. Participants: Of 13 105 individuals who had either a single HbA1c result ≥7.0% (53 mmol mol−1); or two or more HbA1c tests within the study period. Main outcome measures: Frequency of testing of HbA1c and blood lipids (cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol and triglycerides) were compared with guideline recommendations. Results: About 58.3% of patients did not have the recommended 6-monthly HbA1c tests and 30.6% did not have annual lipid testing. For those who did not receive tests at the recommended interval, the mean between-test interval was 10.5 months (95% CI = 7.5–13.5) rather than 6 months for HbA1c testing; and 15.7 (95% CI = 13.3–18.1) months rather than annually for blood lipids. For those with at least one out-of-range test result, 77% of patients failed to receive a follow-up HbA1c test and 86.5% failed to receive a follow-up blood lipid test within the recommended 3 months. Patients less than 50 years of age, living in a more remote area and with poor diabetes control were less likely to have testing at the recommended intervals (P < 0.0001). Conclusions: Although poor diabetes testing is not limited to rural areas, more intensive diabetes monitoring is likely to be needed for patients living in non-metropolitan areas, particularly for some subgroups.
AB - Objective: To indicate levels of monitoring of type 2 diabetes in rural and regional Australia by examining patterns of glycated haemoglobin (HbA1c) and blood lipid testing. Design and Setting: Retrospective analysis of pathology services data from twenty regional and rural towns in eastern Australia over 24 months. Participants: Of 13 105 individuals who had either a single HbA1c result ≥7.0% (53 mmol mol−1); or two or more HbA1c tests within the study period. Main outcome measures: Frequency of testing of HbA1c and blood lipids (cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol and triglycerides) were compared with guideline recommendations. Results: About 58.3% of patients did not have the recommended 6-monthly HbA1c tests and 30.6% did not have annual lipid testing. For those who did not receive tests at the recommended interval, the mean between-test interval was 10.5 months (95% CI = 7.5–13.5) rather than 6 months for HbA1c testing; and 15.7 (95% CI = 13.3–18.1) months rather than annually for blood lipids. For those with at least one out-of-range test result, 77% of patients failed to receive a follow-up HbA1c test and 86.5% failed to receive a follow-up blood lipid test within the recommended 3 months. Patients less than 50 years of age, living in a more remote area and with poor diabetes control were less likely to have testing at the recommended intervals (P < 0.0001). Conclusions: Although poor diabetes testing is not limited to rural areas, more intensive diabetes monitoring is likely to be needed for patients living in non-metropolitan areas, particularly for some subgroups.
KW - diabetes mellitus
KW - HbA1c
KW - patient care management
KW - rural health
KW - vulnerable populations
UR - http://www.scopus.com/inward/record.url?scp=84963499170&partnerID=8YFLogxK
U2 - 10.1111/ajr.12283
DO - 10.1111/ajr.12283
M3 - Article
VL - 24
SP - 371
EP - 377
JO - Australian Journal of Rural Health
JF - Australian Journal of Rural Health
SN - 1038-5282
IS - 6
ER -