In a study from Western Sydney University, scientists found that a short 15–20 minute discussion between a local endocrinologist and general practitioner (GP) is improving the care of people with complex type 2 diabetes.
The study is the first evaluation of “patient-free” diabetes case conferencing.
This is a model where, with the patient’s consent, an endocrinologist visits a GP practice, alongside a practice nurse or diabetes educator, to collaborate on the care of patients to develop a joint management plan for the patient.
The team found blood glucose (HbA1c), blood pressure, weight, as well as other heart risk factors all improved following the three-year trial.
They tested more than 600 patients with type 2 diabetes from 40 general practices across southwestern Sydney.
Blood glucose results strongly improved between 2017 and 2020, with more than a third (37%) of patients within the target range compared with just one in five (20%) before the program.
In addition, more than three-quarters (77%) of patients recorded systolic blood pressure within the target range on follow-up, compared with less than half of patients (47%) in 2017.
The findings suggest the model made a significant contribution to diabetes management in primary care settings.
The findings add to the evidence suggesting that case conferencing programs can help close the gaps in service provision such as barriers between different settings, improve the patient experience by accommodating more complex cases in primary care, and reduce duplication of care.
The team says this is a real win-win-win for patients, GPs, and the health system:
Patients get specialist input into their care without any extra time or cost, GPs can continue to manage their patients using their extra knowledge, and the health system has less demand on hospital clinics, potentially reducing and preventing hospitalizations in people with complex diabetes compared with usual care.
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The study was conducted by Professor David Simmons et al and published in the International Journal of Integrated Care.
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