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National Type 2 Diabetes Prevention Program

National Type 2 Diabetes Prevention Program. Why diabetes prevention?. There is good evidence that diabetes can be prevented The burden of disease and cost to the economy are significant drivers to action General Practice is well placed to play a central role in any diabetes prevention program.

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National Type 2 Diabetes Prevention Program

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  1. National Type 2 Diabetes PreventionProgram

  2. Why diabetes prevention? • There is good evidence that diabetes can be prevented • The burden of disease and cost to the economy are significant drivers to action • General Practice is well placed to play a central role in any diabetes prevention program

  3. Background The National Type 2 Diabetes Prevention program is an initiative of the Council of Australian Governments Part of the National Reform Agenda Federal and state strategies have been allocated funding Activity has begun across the country

  4. Commonwealth commitment Commonwealth Government commitment: $103.4M Development of an Australian type 2 diabetes risk assessment tool New Medicare item number to assess risk in 40-49 yo’s Patients at high risk can be referred by their GP to a local accredited Lifestyle Management Program (LMP) Development of national LMP standards for accreditation Divisions network funded to purchase and/or provide LMPs

  5. Purpose: To support general practice to address the health needs of patients 40-49 years of age who are at ‘high risk’ of developing type 2 diabetes. Patient eligibility: 40-49 years of age At “high risk” of diabetes as defined by the NRAT Has not already developed diabetes Has not had an item 717 claimed in the past 3 years MBS Item 713 – diabetes risk review

  6. MBS Item 713 – diabetes risk review • Components of check • Review of the factors underlying the AUSDRISK ‘high risk’ score • Updating patient history • Examinations and investigations • Initiating interventions where possible • Providing advice and information • Considering referral to an LMP

  7. MBS Item 713 – diabetes risk review • Role of PN, Aboriginal Health Workers or other health professionals in assisting GPs deliver item 713 • Identification of eligible patients • Patient information collection • Information provision to patients

  8. Medicare items processed from July 2008 to September 2008 • Victorian services under item 713 737 • A total of 2850 services nationally

  9. Relationship between MBS items • A GP cannot conduct an item 713, if a previous 713 has been conducted within the previous 3 years. • A person who has previously accessed a 45-49 year health check (item 717), can only become eligible for a type 2 diabetes risk evaluation (item 713) when 3 years have elapsed. • A previous item 713 does not preclude an eligible person from accessing item 717 in relation to the risk of developing other chronic illnesses

  10. Item 717 – 45-49 health check 3 years 1 day Item 713 – Diabetes risk review Relationship between items

  11. Lifestyle Modification Programs Randomised Control Trials have provided strong evidence that lifestyle modification can prevent or delay the onset of type 2 diabetes. Nationally consistent service delivery will be facilitated by and accreditation process based on nationally agreed, evidence based LMP service standards.

  12. National LMP Standards • These core standards have been developed to guide type 2 diabetes prevention programs being implemented as part of the national diabetes prevention program. • Diabetes prevention programs will be accredited if it can be illustrated that the program content and presentation meets the National LMP standards

  13. What information will an accredited LMP include? • Risks of diabetes and their relationship to lifestyle risk factors • Importance of regular diabetes screening • Nutrition advice and education • Physical activity advice • Behavioral strategies to support the adoption and maintenance of lifestyle change • Smoking cessation and alcohol reduction advice if required • Information about community resources relevant to sustaining lifestyle change

  14. What will an accredited LMP look like? • Face to face delivery • Group or individual sessions with groups no larger than 15 participants • Minimum of 8 hours of contact time • Initial intensive phase of at least 4 months duration • End program follow up session at least 6 months after commencement of the program • Providers must be able to illustrate their ability to meet core competencies outlined in program standards

  15. Accreditation Accreditation will ensure that LMPs meet the National LMP Standards Only accredited LMPs will be able to claim a rebate for service delivery. Accreditation system is now in place. See becoming an accredited provider on the AGPN web site: http://www.agpn.com.au/site/index.cfm?display=38797

  16. Accredited LMPs in Victoria • Both ‘RESET your life’ & Life! are accredited to deliver LMP services to patients 40-49 years • Details of all accredited LMP providers to be uploaded onto AGPN web site within the next few weeks

  17. LMP Patient eligibility 40 – 49 years or Aboriginal patients between 15 and 54 years At “high” risk of diabetes as determined by the Australian type 2 diabetes risk assessment tool Have not attended a LMP previously Has had existing diabetes excluded Provided consent Referred by usual GP through 1 of 3 possible item numbers: 713; 717 or 710

  18. Start here↓ Referral pathway / decision support Is your patient of ATSI origin and 15—54 years and eligible for the ATSI health check? Is your client aged 40-49 years? NO Usual care including use of the Lifescripts suite of resources YES NO NO YES Is your patient of ATSI origin and eligible for the ATSI health check? Is your patient at high risk of developing diabetes as defined by the Australian type 2 diabetes risk assessment tool? Item 710—Aboriginal and Torres Strait islander health check Does your patient have diabetes? YES YES YES Item 717—45-49 year health check NO Is your patient 45-49 years old & eligible for a 45-49 year health check? YES Discuss options and consider a referral to LMP if patient is agreeable Complete GP referral to LMP and provide referral to patient or send directly to your local LMP provider. See your local Division for details of your local LMP services If eligible Item 713: Type 2 Diabetes Risk Evaluation Does your patient have diabetes? Is your patient at ‘high risk’ of diabetes as defined by the Australian type 2 diabetes risk assessment? (40—49 yrs) Usual care including diabetes annual cycle of care and GP Management plan and team care arrangement Does your patient have diabetes? NO YES NO NO NO YES NO

  19. LMP evaluation Aim On-line capture Enrolment-mid-end point data GP referral forms/LMP feedback forms Why capture this data? What can this data be used for – locally-state level - nationally

  20. Service Delivery (LMP) funding • 136 000 expected referrals over 3 years • $210 subsidy per patient • $50 co-payment • $260 subsidy for patients with health care or concession cards. • 3 scheduled payments to LMP providers ad program enrolment, completion of intensive phase and end program.

  21. Web resources • AGPN Prevention of type 2 diabetes program web site: http://www.agpn.com.au/site/index.cfm?display=35338 • DoHA: Type 2 diabetes risk evaluation http://www.health.gov.au/internet/main/publishing.nsf/Content/Diabetes-Risk_Evaluation

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