Published articles about patient and general practice experience with Life!

Life! Taking Action on Diabetes – The Lincolnville Clinic Experience

Life! A Patient's Story

Life! Taking Action on Diabetes – The Lincolnville Clinic Experience.

At Lincolnville Clinic East Keilor, we have referred over 40 patients to Life! Taking Action on Diabetes courses since July 2009. This has resulted in both financial benefit to the practice and health benefits for patients.

We are a busy practice, having eight GP consulting rooms and two nurses working Monday to Friday.

I am a Registered Nurse with an interest in diabetes, health prevention and patient education. Evidence and research supports my belief that health prevention has far better outcomes for the individual and the health care provider in the long term. It is also reported that for every patient with diabetes, there is another living with it unknown. Early diagnosis and prevention can reduce the complications associated with diabetes, such as heart attack, stroke, blindness, kidney failure, and amputations. The Life! course is a Lifestyle Modification Program (LMP) that supports early intervention. It is designed to help individuals prevent and/or delay the onset of Type 2 Diabetes.

With support and encouragement from impetusTM staff, I began planning an easy way to implement Life! at our clinic. I discussed with our GPs ideas for simple, quick ways to screen patients and we decided on opportunistic screening from our waiting room. I contacted Diabetes Australia – Victoria (DA-Vic) to order supplies such as the Australian Type 2 Risk Assessment Tool (AUSDRISK), referral pads, information flyers, posters, promotional pens, tape measures and plastic display units.

I attached a simple note to each AUSDRISK asking for patient contact details and explaining if they scored over 15 a nurse would call to discuss referral to Life! Reception staff encouraged patients aged over 50 years to complete AUSDRISK while in the waiting room. A stand with assessment forms and information, along with a box in which to place completed forms, was placed at our reception desk. I would arrange for GPs to screen high risk patients during their next consultation.

When Fasting Blood Glucose was over 5.5mmol/L an agreement was made to follow the DA-Vic and Royal Australian College of General Practitioners guidelines to send patients for Oral glucose Tolerance Test (OGTT). This agreement was reached following a presentation to our GPs by a local Life! facilitator. I would then follow up with completing referral form and faxing it direct to DA-Vic, who in turn contacted the patient and confirmed their preferred course location and time.

Alternatively, patients could make a 15 minute appointment to see me, complete the assessment and discuss the course. A phone call was sufficient if the patient had been seen recently by their GP and recent FBG’s and cholesterol levels had been checked. If the patient was not eligible for referral (see italics below), but high risk, lifestyle information was given and the patient encouraged to reassess with their GP annually.

For each patient who participates in the course, the referring GP receives feedback from the course provider on patient progress. Results indicate the course is reducing the risk of diabetes by 58%.

Under the DA-Vic case finding agreement, $560 (+GST) is available to each practice every time 15 referrals for patients aged 50 and over are made. I created a folder for nursing staff to record each patient referred to DA-Vic to assist with funding claims.

I have found the experience beneficial to our clinic; it has made our GPs and Nurses more aware about diabetes and the risk factors associated with diabetes. It has also provided accurate screening of patients and encouraged more FBG’s and OGTT’s. The financial incentive from DA-Vic has been an added bonus. We are saving this to help our clinic purchase a Doppler machine to enhance wound care! It has also provided me with the opportunity to practice Primary Nursing Care which is something I really enjoy.

Kerryn Edgar

Published in Advance: Newsletter of Impetus, Progressive Primary Health Limited, March 2010.
Reproduced with permission from Impetus

Life! A Patient's Story

Colin was referred to the Life! program by his GP after he scored 17 on the AUSDRISK tool. He had Type 2 Diabetes excluded, but he was assessed to be at high-risk for developing the condition. Life! program officer Sarah Bowman chatted to Colin after he attended a Life! course held at Greater Eastern Primay Health.

How did it feel to be referred to the Life! program?

I have to admit, I had no idea that I was at risk of developing Type 2 Diabetes. I really didn't know much about diabetes. But my doctor told me that I could go to a 6 session course with other people my age, to learn about how I can prevent it. I was a bit skeptical at first, but I went to the first session and actually learned a lot!

What has been the best part of the course?

I have met a lot of people in the Life! course and we all support each other to become healthier and lose some weight. Some of us are swapping healthy meal ideas too. Tanith, our course facilitator, has been so helpful and has answered all of our questions! And it was free!

What has been the most challenging part of the course?

It's always hard to make changes to the way you live your life – but Life@ has helped me get the ball rolling. I thought I didn't have the time for exercise, but I just needed to find different ways to work it into my week.

Would you recommend the Life! course to others?

Yes, I would. I've learned to take control of my health and to take better care of myself. I've lost weight, and I feel less stressed too.

Sarah Bowman

Published in Greater Easter Primary Health newsletter, January 2010.
Reproduced with permission from Greater Eastern Primary Health.