4. Analysis of data

The information that TAADIS collects can be used to build profiles of patient groups and identify which patients and GPs to target with an intervention.   It also allows the Division to observe changes in outcomes for cohorts of patients over time.


Physical Activity Referral Pilot Project

TAADIS patients with an HbA1c greater than 7% (considered to be at higher risk of diabetes complications) were invited to participate in a joint project involving the Division and the Department of Biomedical Sciences at the University of Wollongong.  The pilot project, which ran in semester 2,  2004, involved testing a model of GP referral to Exercise Physiologists for assessment, program design and participant support.   Key elements of the pilot project were:

  • Participants received a fitness assessment and received a personalised physical activity program based on their capabilities, health status and exercise preferences.  

  • Participants attended a group session at the start and half way through the 11 week program.

  • Participants received six supervised sessions and at other times undertook their exercise programs independently with telephone support as required.  

  • Programs could be undertaken in a fitness centre or at home.  


  • Pathology testing of HbA1c, fructosamine and lipids was undertaken at the beginning and completion of the project.

  • Generous support for the pilot was provided by the following companies:  Heart Monitors and pedometers were provided by Health Management Group ph 1800 000 180 and exercise equipment was provided by Ausmedic Australia  ph 1800 245 169.   Free use of gym facilities was offered by Beaton Park Leisure Centre, Wests Gym and Lakeside Leisure Centre.  Testing was provided by Mayne Laverty Pathology and Southern IML Pathology.

  • Analysis of pre and post test data showed that changes in HbA1c, fructosamine, waist circumference, resting blood pressure, resting heart rate, cardiorespiratory fitness and upper and lower body strength were statistically significant for the pilot group.

Following the success of the pilot, this initiative was incorporated into the Diabetes program.  The GP Exercise Referral Program (GPEP) is run twice a year with in excess of 130 people having been enrolled to date.

Education

Quarterly education workshops are offered to program GPs regarding best practice in diabetes management.  An Active Learning Module is being conducted in 2006.  Educational topics for the year are: Motivational interviewing, insulin and insulin devices, the glycaemic index, risk factor management in general practice and using IT in diabetes management.  

Information is sent to patients each quarter on the topics covered by the GP quarterly education workshops.  A survey of patient satisfaction with educational material conducted in 2002, showed that patients perceived benefits such as motivation to improve blood sugar testing and glycemic control.

Diabetes Service Directory and Patient Information Booklet is a resource produced for GPs to give to newly diagnosed diabetes patients.

Practice Support

Information and support is provided to GPs and practice staff regarding

  • Systems for chronic disease management

  • Recalling patients using Medical Director

  • Claiming diabetes incentives  

Planning

The Division hosts the Illawarra Diabetes Task Force, a group of diabetes stakeholders including the Illawarra Diabetes Service, which sets the strategic direction for diabetes programs and services in the Illawarra.  

The Diabetes Program GP Reference Group, which meets three times a year, allows GP representatives to provide direct advice to the TAADIS program officer on the practical implementation of TAADIS program activities.

The data collected by TAADIS also enables the Division to address research questions regarding the potential impact of the program on patient health outcomes.

Program Evaluation

An independent evaluation of the Diabetes Trial (1999-2003) was undertaken as a joint initiative by CEPHRIS (Centre for Equity in Primary Health Research in the Illawarra and Shoalhaven).

A study completed in 2005 compared TAADIS diabetes data collected during 2000-2002 and the NDDP (National Division Diabetes Program) which collected data from 16 Divisions.  

Both TAADIS and NDDP groups had some positive changes in clinical indicators within the group but HbA1c was significantly reduced in TAADIS, when compared to the NDDP. 

In TAADIS, blood pressure and HbA1c were significantly decreased and HDL significantly increased although there were no statistically significant changes in LDL, T-CHOL, TG or BMI.

 (Source: Centre for Equity and Primary Health Research in Illawarra and Shoalhaven, 2005)