Diabetes Alliance Program Plus (DAP+) to serve rural and remote communities

A $12.4m philanthropic gift from the Colonial Foundation will assist in developing and implementing rural and remote community focused Diabetes Alliance Program (DAP) intervention. Led by Hunter Medical Research Institute, and in partnership with Hunter New England Local Health District (HNELHD), Hunter New England Central Coast Primary Health Network (HNECCPHN), and the University of Newcastle, the grant will allow the expansion of the existing Diabetes Alliance Program (DAP), with the expanded program titled the DAP+ program.

One in 10 people in the Hunter New England region have diabetes and more than half of them are unaware, with data indicating incidence of the disease in the region (12.3 per cent), is higher than the NSW state average (11.3 per cent).

According to Diabetes Australia, Diabetes is the fastest growing chronic condition in Australia, with one person diagnosed with the disease every five minutes nationally. Aboriginal and Torres Strait Islander Australians are three times more likely to develop type 2 diabetes than non-Indigenous Australians. Diabetes increases the chances of premature death, cardiovascular disease such as heart attacks and stroke, amputations, kidney failure requiring dialysis and blindness when sub-optimally managed. Read more about diabetes in Australia.

The Diabetes Alliance Program began as a partnership program between HNELHD and HNECCPHN in 2014 to manage diabetes within the community. DAP supports primary care clinicians by providing them with the tools they need to deliver best evidenced care and improve clinical outcomes for people living with diabetes. The program involves conducting case conferences with GPs, practice nurses and patients with visiting diabetes specialist teams comprising of an endocrinologist and diabetes educator at patients’ own GP surgery. While individual patients improve their diabetes outcomes, primary care clinicians receive intensive capacity-building knowledge from the visiting specialist team, enabling them to manage the many patients with diabetes in their practice with minimal need to refer, reducing the time it takes for patients to receive best evidenced care.

The sessions have been well received in the region, with 143 general practices having already participated. More than 550 GPs and 150 practice nurses have taken part in DAP in the Hunter New England region, with demand for the service so high that a waitlist has been developed. In addition to case conferences, the DAP+ team provide clinician education alongside local experts across HNELHD.

Evaluation of DAP shows not only significant improvements in diabetes related outcomes for those who participated in this model, but also a ‘spill over’ effect to rest of the practice patients from the lessons learned, as per Associate Professor Shamasunder Acharya, who has the led the program with his team since 2014. ‘For every 1000 case conferences conducted in GP practices, a total 22000 patients receive benefits in addition through knowledge dissemination he said. DAP+ will focus a significant proportion of their resources on rural and remote towns within the HNELHD initially, with plans to expand to wider NSW in the future. The team will conduct a series of town events aimed at health promotion, physical activity and healthy nutrition led by Professor Ron Plotnikoff and Professor Claire Collins from the University of Newcastle. Along with Diabetes Australia, the DAP+ team aims to raise awareness that diabetes is a silent disease that if left untreated, can lead to detrimental pain and suffering for those affected, their families and community as a whole.

The DAP+ program will be commissioning a Medibus with state of art facilities for outpatient consultation on the go as needs are identified in collaboration with local communities, linking specialist teams with primary care teams and patients in rural and remote communities.

HMRI Director Professor Frances Kay-Lambkin said the program would be comprehensively evaluated to ensure it was meeting its goals.

CEO of the Colonial Foundation Mr. André Carstens said “The expected outcomes from this program are immense, not only will our rural and remote communities receive better diabetes care at-scale, but we anticipate there will be spill-over effects on the health system including economic benefits due to the preventable nature of this chronic disease,” Mr Carstens said.

The team will be visiting Moree from the 1-5^th May with a clinician event scheduled on Thursday 4^th May.