title: Comparison of two methods for assessing diabetes risk in a pharmacy setting in Australia.
abstract: BACKGROUND
  Since 2007, the Australian Know your numbers (KYN) program has been used in community settings to raise awareness about blood pressure and stroke. In 2011, the program was modified to include assessment for type 2 diabetes risk. However, it is unclear which approach for assessing diabetes risk in pharmacies is best. We compared two methods: random (non-fasting) blood glucose testing (RBGT); and the Australian type 2 diabetes risk assessment tool (AUSDRISK); according to 1) identification of 'high risk' participants including head-to-head sensitivity and specificity; 2) number of referrals to doctors; and 3) feasibility of implementation.
  
  
  METHODS
  117 Queensland pharmacies voluntarily participated and were randomly allocated to RBGT and AUSDRISK or AUSDRISK only. Although discouraged, pharmacies were able to change allocated group prior to commencement. AUSDRISK is a validated self-administered questionnaire used to calculate a score that determines the 5-year risk of developing type 2 diabetes. AUSDRISK (score 12+) or RBGT (≥5.6 mmol/I) indicates a high potential risk of diabetes. Median linear regression was used to compare the two measures. Staff from 68 pharmacies also participated in a semi-structured interview during a site visit to provide feedback.
  
  
  RESULTS
  Data were submitted for 5,483 KYN participants (60% female, 66% aged >55 years, 10% history of diabetes). Approximately half of the participants without existing diabetes were identified as 'high risk' based on either RBGT or AUSDRISK score. Among participants who undertook both measures, 32% recorded a high RBGT and high AUSDRISK. There was a significant association between RBGT and AUSDRISK scores. For every one point increase in AUSDRISK score there was a half point increase in RBGT levels (coefficient 0.55, 95% CI: 0.28, 0.83). Pharmacy staff reported that AUSDRISK was a simple, low cost and efficient method of assessing diabetes risk compared with RBGT, e.g. since management of sharps is not an issue.
  
  
  CONCLUSIONS
  In a large, community-based sample of Australians about half of the participants without diabetes were at 'high risk 'of developing diabetes based on either AUSDRISK or RBGT results. AUSDRISK was considered to be an acceptable method for assessing the risk of diabetes using opportunistic health checks in community pharmacies.
authors.affiliation: Stroke and Ageing Research School of Clinical Sciences at Monash Health, Monash University, Level 1/43-51 Kanooka Grove, Clayton, 3168 Melbourne, VIC, Australia. monique.kilkenny@monash.edu.
authors.forename: Monique F
authors.initials: MF
authors.lastname: Kilkenny
authors.forename: Roslyn
authors.initials: R
authors.lastname: Johnson
authors.forename: Nadine E
authors.initials: NE
authors.lastname: Andrew
authors.forename: Tara
authors.initials: T
authors.lastname: Purvis
authors.forename: Alison
authors.initials: A
authors.lastname: Hicks
authors.forename: Stephen
authors.initials: S
authors.lastname: Colagiuri
authors.forename: Dominique A
authors.initials: DA
authors.lastname: Cadilhac
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia; D001786:Blood Glucose; D001795:Blood Pressure Determination; D002648:Child; D002675:Child, Preschool; D003157:Community Pharmacy Services; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011793:Queensland; D012017:Referral and Consultation; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose