A program to improve management of patients with type 2 diabetes

Abstract

Type 2 diabetes is responsible for a large burden of disease globally and in Australia, it is most commonly managed in general practice. For this reason, NPS MedicineWise has run sequential programs since 2000 in primary care to support optimal management of the condition. This chapter outlines the program implemented in 2016-2017. The objectives of the program were to improve adherence to diabetes medicines, especially metformin; to promote use of sulfonylureas second line; and to support the use of a treatment algorithm for stepping up management if diabetes was not controlled. The program included educational outreach visits, clinical audits, feedback of prescribing data and a shared decision-making tool for general practitioners. There were also patient materials to encourage sound understanding of diabetes medicines and the long term benefits they bring. Design briefs and analysis of the relevant enablers and barriers to change are provided to explain the selection of interventions. The program had record participation rates among general practitioners and improvements were found in the knowledge and confidence of participating GPs who said they had a clearer plan for stepping up treatment appropriately. There were also improvements in clinical indicators such as HbA1c and LDL-cholesterol targets being met.