Doris Young, John Furler, Christine Walker, Margarite Vale, James Best, Leonie Segal, Trisha Dunning (NHMRC GP clinical research grant July ) PEACH: Patient Engagement And Coaching for Health an intensive intervention for patients with Type 2 Diabetes

Background Treatment gap worse for disadvantaged communities, less likely to see GPs and specialists, lower rates of lipid testing Good evidence from clinical trials that intensive treatment interventions reduce biological risk factors and reduce morbidity/mortality * (*Gaede et al. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes: N.Engl J Med. 2003; 348: )

Hypothesis Supporting patients with poorly controlled T2D through individual coaching by existing practice nurses in GP clinics will improve process of care and health outcomes compared with usual GP care and this approach will be cost effective

Aim To determine the effectiveness of a patient focused method for chronic disease self management (COACH program) in order to achieve intensive treatment goals for T2D in a GP setting

PEACH study flowchart Intervention Usual GP care + COACH program Control Usual GP care Follow-up assessments at 12 and 18 months Recruit eligible participants Appointment with PN  Explain study  Obtain consent  Baseline data collection Inclusion Criteria  Type 2 diabetes patients >18yrs  HbA1c>7.5% Mail out from Practices Optional follow-up phone calls by PN Second mail out from Practices Exclusion Criteria  No phone number  Other complex debilitating medical condition Generate list of up to 40 eligible patients from each Practice Randomise Practices

Primary Outcome Change in HbA1c level from baseline to 12 and 18 months post-randomisation in the intervention group compared with the control group

Secondary Outcomes  BP, BMI, waist  Smoking cessation (urinary cotinine at 18 months)  Diabetes self efficacy  Quality of Life (AQOL)  Depression screening  Hospitalisation and health service utilisation  Process of GP care, blood tests  Diabetes, anti-HT,statin, aspirin  TC, TG, LDL, HDL  Urinary albumin  Physical activity and Diet

What’s in it for the practice? Training the PN to identify diabetes patient population Reimbursement for PN participation Chance to access free diabetes education for the PN COACH training for those involved in the intervention group Paid 2 hr briefing session

What’s in it for the PN? Increased knowledge of diabetes Expand your role Expand your research skills Certificate pf participation CPD points Free COACH training in the intervention group Free COACH training to all if it proves successful

What’s in it for the GP? Improving care and health outcomes Support in care planning and annual cycles of care QA&CPD points Detailed feedback on patients Research training for interested GP’s

Contact Dr Irene Blackberry Thank You

Prof Doris Young, Principal Investigator, Dept of GP, The University of Melbourne, 200 Berkeley St, Carlton VIC PEACH: Patient Engagement And Coaching for Health an intensive intervention for patients with Type 2 Diabetes