Comparison of different stepwise screening strategies for type 2 diabetes: Finding from Danish general practice, Addition-DK.
OBJECTIVE
To examine attendance, number of people with T2DM and costs of three different stepwise screening strategies for T2DM in general practice (GP).


METHODS
Diabetes risk questionnaires were mailed to individuals aged 40-69 years from 45 general practices in 2001-2002 and individuals at high risk for T2DM, were asked to contact their GP to arrange a screening test. In 2005-2006, 26 general practices were randomised into two different opportunistic screening programmes (OP-direct and OP-subsequent) and risk questionnaires were distributed to individuals aged 40-69 years during GP consultations. In the OP-direct approach, high-risk individuals were offered to start the screening during the actual consultation while high-risk individuals in the OP-subsequent approach, were invited to a screening test at a later date. We report attendance, number of people with T2DM and costs of each screening approach.


RESULTS
The mail-distributed approach identified 0.8% of the target population with T2DM, the OP-direct approach and the OP-subsequent approach, 0.9% and 0.5% respectively. Cost per person with T2DM was in the mail-distributed approach: € 1058, OP-direct approach: € 707 and the OP-subsequent approach: € 727.


CONCLUSIONS
This study indicates that opportunistic screening identifies the same level of unknown diabetes as a mail-distributed approach but with lower costs.
Dalsgaard
Else-Marie
EM
Department of General Health, Aarhus University, Denmark. emdl@alm.au.dk
Christensen
Jesper O
JO
Skriver
Mette Vinter
MV
Borch-Johnsen
Knut
K
Lauritzen
Torsten
T
Sandbaek
Annelli
A
D000328:Adult; D000368:Aged; D001071:Appointments and Schedules; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D016009:Chi-Square Distribution; D017046:Cost Savings; D003718:Denmark; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis* / Q000191:economics; D005260:Female; D058006:General Practice / Q000191:economics; D005951:Glucose Tolerance Test / Q000191:economics; D006442:Glycated Hemoglobin / Q000378:metabolism; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000379:methods*; D008875:Middle Aged; D011237:Predictive Value of Tests; D012017:Referral and Consultation / Q000191:economics; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires / Q000191:economics
D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human