Pharmacy diabetes care program: analysis of two screening methods for undiagnosed type 2 diabetes in Australian community pharmacy.
OBJECTIVE
To compare the efficacy and cost-effectiveness of two methods of screening for undiagnosed type 2 diabetes in Australian community pharmacy.


METHODS
A random sample of 30 pharmacies were allocated into two groups: (i) tick test only (TTO); or (ii) sequential screening (SS) method. Both methods used the same initial risk assessment for type 2 diabetes. Subjects with one or more risk factors in the TTO group were offered a referral to their general practitioner (GP). Under the SS method, patients with risk factors were offered a capillary blood glucose test and those identified as being at risk referred to a GP. The effectiveness and cost-effectiveness of these approaches was assessed.


RESULTS
A total of 1286 people were screened over a period of 3 months. The rate of diagnosis of diabetes was significantly higher for SS compared with the TTO method (1.7% versus 0.2%; p=0.008). The SS method resulted in fewer referrals to the GP and a higher uptake of referrals than the TTO method and so was the more cost-effective screening method.


CONCLUSIONS
SS is the superior method from a cost and efficacy perspective. It should be considered as the preferred option for screening by community based pharmacists in Australia.
Krass
I
I
Faculty of Pharmacy, Sydney University, NSW 2006, Australia. inesk@pharm.usyd.edu.au
Mitchell
B
B
Clarke
P
P
Brillant
M
M
Dienaar
R
R
Hughes
J
J
Lau
P
P
Peterson
G
G
Stewart
K
K
Taylor
S
S
Wilkinson
J
J
Armour
C
C
D001315:Australia / Q000453:epidemiology; D001786:Blood Glucose / Q000032:analysis*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D006331:Heart Diseases / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010594:Pharmacies / Q000592:standards; D012016:Reference Values; D012017:Referral and Consultation; D012307:Risk Factors
D001786:Blood Glucose