Prevention of Type 2 Diabetes Program
Background
In April 2007 the Council of Australian Governments (COAG) agreed to a cost shared package of over $200 million to address the significant increase in the incidence of Type 2 Diabetes in the Australian population. The Australian Government announced that its major contribution to this measure will focus on people in the 40-49 year old age group with the objective of reducing or delaying their progression to Type 2 Diabetes.
The Australian General Practice Network (AGPN) has been funded by the Department of Health & Ageing (DoHA) to roll out the National Type 2 Diabetes Prevention Program via the Divisions Network.
A key component of the Prevention of Type 2 Diabetes Program is a referral pathway for General Practitioners (GPs) for eligible patients to access an accredited, subsidised Lifestyle Modification Program (LMP).
The WA General Practice Network (WAGPN) has been contracted by AGPN to support the implementation of this initiative in Western Australia, via the local Division Networks.
The local Divisions will:
- Provide support for local general practices to utilise the appropriate Health Assessment items.
- Promote referral pathways to available local subsidised LMPs
- Engage with local LMP providers.
- In some circumstances deliver LMPs.
What is a Lifestyle Modification Program?
A Lifestyle Modification Program will assist people to modify factors contributing to their risk, as a way of delaying or preventing the progression to Type 2 Diabetes. A typical program will include a series of group motivational and education sessions supporting lifestyle changes and adoption of healthy lifestyle choices. The program consists of seven group sessions with an initial intensive phase (6 sessions) over at least 4 months duration with a subsequent end program follow-up session at least 6 months after the commencement of the program.
A GP referral to a subsidised LMP can follow a MBS Health Assessment for:
• Patients 40-49 years of age at high risk of developing Type 2 Diabetes,
• Patients 45-49 years of age at risk another chronic disease (besides Diabetes) or
• Aboriginal and Torres Strait Islander adults (15-54 years of age).
Evidence for Lifestyle Modification Programs
Landmark intervention studies in China (The China Da Qing Diabetes Prevention Study), the US (The Diabetes Prevention Program) and Finland (The Finnish Diabetes Prevention Program) have shown that sustainable lifestyle interventions in people at high risk of developing Type 2 Diabetes, led to significant reductions in the incidence of diabetes, by up to 58 percent.
Relevant MBS Health Assessment items:
MBS items 701 (brief <30mins); 703 (standard – 30-45mins); 705 (long 45-60mins) or 707 (extended > 60mins) are available to GPs for reviewing patients 40 to 49 years of age who are at high risk of developing Type 2 Diabetes (score of ≥ 12 on the AUSDRISK).
MBS item 715 – Aboriginal & Torres Strait islander (ATSI) people 15-54years.
As a component of the assessment the GP can then instigate early interventions to assist in the prevention of Type 2 Diabetes by providing advice regarding lifestyle risk factors identified and to consider referral to a subsidised Lifestyle Modification Program (LMP).
Australian Diabetes Risk Assessment Tool (AUSDRISK)
The AUSDRISK tool assesses risk factors, such as age, gender, country of birth, family history of diabetes, history of high blood pressure, smoking status, fruit and vegetable intake, physical activity levels and waist circumference.
The AUSDRISK tool can be completed by the patient or with the assistance of a member of the practice team. Once a patient has calculated their score, they are encouraged to speak with their GP to discuss the factors contributing to their risk of developing Type 2 diabetes.
The AUSDRISK tool is a nationally agreed risk assessment tool to assess a person's risk of developing Type 2 diabetes within the next five years and has been developed by the International Diabetes Institute (Baker IDI), based on the Finnish Type 2 Diabetes Risk Score - or FINRISC - and has been adapted for the Australian population.
The AUSDRISK tool is available for download from the Department of Health and Ageing website at www.health.gov.au/preventionoftype2diabetes Hard copies can be ordered through the National Mailing and Marketing by email nmm@nationalmailing.com.au; fax (02) 6260 2770 or Phone (02) 6269 1080.
Resources:
LMP referral pathways Flowchart
Current list of accredited Lifestyle Modification Programs in Western Australian
GP Referral Form
Completion of Intensive Phase Feedback Form
End Program Feedback Form
Invoice Schedule
Invoice Template
Prevention of Type 2 Diabetes Program – LMP Operational Guidelines
Prevention of Type 2 Diabetes Program – LMP Program Guidelines
Links:
Australian General Practice Network
Type 2 Diabetes Prevention Program / Lifestyle Modification Programs
- Information and Resources.
Australian Department of Health and Ageing
Information and resources for Prevention of type 2 Diabetes Program
Medicare Benefits Schedule online
For detailed descriptors and explanatory text for MBS item numbers