Prevention of Type 2 Diabetes
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OverviewThe Council of Australian Governments (COAG) agreed in April 2007 to a cost share package with the aim of addressing the issue of a significant growth in type 2 diabetes. As part of this agreement the Australian Government announced a focus on people aged 40 to 49 years of age at high risk of developing type 2 diabetes, using the newly developed Australian Type 2 Diabetes risk Assessment Tool (AUSDRISK). A new Medicare Item, the Type 2 Diabetes Risk Evaluation (item 713), was also introduced in July 2008 to enable GPs to provide assessment of patient risk of developing type 2 diabetes, and risk modification advice to eligible patients. As part of this advice, GPs may refer eligible patients to a lifestyle modification program (LMP) which is aimed at modifying patient's lifestyle behaviours to reduce or delay progression to type 2 diabetes. In order to be eligible for both the Risk Evaluation and referral to an LMP a patient must be aged 40-49 years and be at high risk of developing type 2 diabetes according to the AUSDRISK tool, but not yet have type 2 diabetes (see MBS online for full details of eligibility). General Practice Tasmania (GPT) has entered into a contract with the Australian General Practice Network to provide support to Divisions of General Practice with GP engagement around the new item number, referrals to the LMPs and post-assessment care. GPT is also acting as the fund-holder and administrator of payments to accredited LMPs. ObjectiveThe objective of the Prevention of Type Two Diabetes Program is to enable eligible patients to undertake a subsidised, accredited lifestyle modification program (LMP) in order to reduce their risk of, or delay the progression to, type 2 diabetes. Clinical trials have provided strong evidence that progression to type 2 diabetes can be prevented or delayed with lifestyle modification. Type 2 diabetes is a largely preventable chronic disease that is becoming increasingly common in Australia. If undetected or poorly controlled, type 2 diabetes can result in acute and long term complications. The purpose of Medicare Item 713 is to support general practitioners to address the health needs of patients 40 to 49 years of age who are at high risk of developing type 2 diabetes.
Australian Type 2 Diabetes Risk Assessment ToolThe Australian Type 2 Diabetes Risk Assessment Tool (AUSDRISK) has been developed by the International Diabetes Institute (IDI) and is based on the Finnish ‘risk test’ but has been adapted for the Australian clinical setting using AUSDIAB data. It has been developed to provide a basis for both health professionals and health consumers to assess the risk of developing type 2 diabetes over a 5 year period. It consists of a short list of questions that, when completed, provide a guide to a patient’s current level of risk of developing type 2 diabetes. The item scores and risk rating calculations in the tool have been developed using demographic, lifestyle, anthropometric and biomedical data from the 2000 Australian Diabetes, Obesity and Lifestyle baseline survey and the AusDiab 2005 follow-up study. The completion of the Australian Type 2 Diabetes Risk Assessment Tool and a high score result will be mandatory for the patient to access Medicare Item 713. It may be completed by either the patient or with the assistance of a health professional or practice staff. Further information and a copy of the Australian Type 2 Diabetes Risk Assessment Tool can be accessed at www.health.gov.au/epc
Lifestyle Modification Program (LMP)An LMP is a subsidised group program for people aged 40-49 who are at high risk of developing type 2 diabetes (using the AUSDRISK tool). The aim of the program is to enable participants to develop strategies to enable them to change their lifestyle to delay or prevent the onset of type 2 diabetes. LMPs will typically be a series of group education and motivation sessions supporting lifestyle change. LMPs must meet the draft standards for lifestyle modification programs for people at risk of type 2 diabetes, and be awarded accreditation before they can start delivering services. For more information on accreditation, visit the Australian General Practice (AGPN) accreditation sub-page. LMP's will provide information on:
Eligibility In order to enrol in a subsidised LMP participants must:
A completed GP referral form must be received by the LMP provider and must have the participant’s signed consent. Referral is only valid for two months. See links and resources below for more information on eligibility criteria and relevant documents.
PartnersEffective primary health care relies on solid relationships and integration between general practice, allied health services, government and non-government sectors. General Practice Tasmania has partnerships with the following organisations:
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