Doris Young, John Furler, Christine Walker, Margarite Vale, James Best, Leonie Segal, Trisha Dunning

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PEACH Patient Engagement And Coaching for
Health an intensive intervention for patients
with Type 2 Diabetes

• Doris Young, John Furler, Christine Walker,
  Margarite Vale, James Best, Leonie Segal, Trisha
  Dunning
• (NHMRC GP clinical research grant July 2005-8)

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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 348 383-93)

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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

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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

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PEACH study flowchart
Generate list of up to 40 eligible patients from
each Practice

• Inclusion Criteria
• Type 2 diabetes patients gt18yrs
• HbA1cgt7.5

• Exclusion Criteria
• No phone number
• Other complex debilitating medical condition

Mail out from Practices
Optional follow-up phone calls by PN
Second mail out from Practices

• Appointment with PN
• Explain study
• Obtain consent
• Baseline data collection

Recruit eligible participants
Randomise Practices
Intervention Usual GP care COACH program
Control Usual GP care
Follow-up assessments at 12 and 18 months
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Primary Outcome

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

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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

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Whats 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

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Whats 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

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Whats in it for the GP?

• Improving care and health outcomes
• Support in care planning and annual cycles of
  care
• QACPD points
• Detailed feedback on patients
• Research training for interested GPs

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Contact

• Dr Irene Blackberry
• 03 8344 3373
• i.blackberry_at_unimelb.edu.au
• Thank You

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PEACH Patient Engagement And Coaching for
Health an intensive intervention for patients
with Type 2 Diabetes

• Prof Doris Young,
• Principal Investigator,
• Dept of GP, The University of Melbourne,
• 200 Berkeley St, Carlton VIC 3053
• Email d.young_at_unimelb.edu.au
• www.peach.unimelb.edu.au