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A patient-centred clinical approach to diabetes care assists long-term reduction in HbA1c

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Summary:

Outcomes are reported from an audit comprising a before-and-after assessment of 185 patients referred to the GPSI Diabetes service – a patient-centred intervention for diabetes management – between 2008 and 2010. The aim of this audit was to determine if this patient-centred intervention improves diabetes care, as measured by changes in glycosylated haemoglobin (HbA1c). The GPSI Diabetes service is a communitybased service, run by a general practitioner with a specific interest (GPSI) in diabetes, and a practice nurse. Adults with diabetes are referred to the service by their GP and care is provided using a set of loosely structured diabetes-specific patient-centred approaches. Following a series of visits, patients are discharged back to their GP. At intake, baseline HbA1c was higher among Māori than among New Zealand Europeans. This difference was reduced by the patient-centred intervention. Immediate and sustained (two-year) improvements in HbA1c were observed in both New Zealand Europeans and Māori with type 2 diabetes and type 1 diabetes. Completed patient and GP satisfaction questionnaires did not contain any negative feedback, but the response rate was low among patients.

Comment:
Useful information here about how to apply the concept of ‘patient-centred care’ in clinical practice.
Reference: J Prim Health Care. 2014;6(3):195-202
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

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