Depression Treatment Evaluation Care Team (D_TECT) (Chronic Disease Management of Co-morbid Depression, Heart Disease and Diabetes – Stage 1)
This project examined the clinical pathways for patients with co-morbid depression and diabetes using six general practices in the National Primary Care Collaboratives, which were required to set up chronic disease management systems with databases for recall. The project sought to determine where best to identify and intervene for patients with diabetes and depression.
Diabetes Prevention Project Initiative
This lifestyle intervention project which aimed to prevent the onset of type 2 diabetes among high risk individuals was undertaken in the Greater Green Triangle region between 2004 and 2006. Behavioural theories were combined with evidence-based intervention goals and strategies so that intervention could be undertaken in a primary health care setting.
Three General Practice Clinics in Hamilton and Horsham in Victoria and Mount Gambier in South Australia, participated in the study. A total of 311 adults were invited to participate in a series of structured group-counselling sessions facilitated by trained project nurses, dieticians and physiotherapists. The sessions aimed to motivate and support participants to adopt lifestyle changes – including modifying diet and physical activity levels – by providing them with the skills and social support needed for these changes to take place.
A new risk assessment tool for identification of patients at high risk of diabetes was introduced and used in this intervention. Results of this project provide evidence that a type 2 diabetes prevention program using lifestyle intervention is feasible in a primary health care setting, with reductions in risk factors approaching those observed in clinical trials.
Diabetes Prevention Project – Telephone Support Follow Up Study
The major aim of this project was to test the effectiveness of a simple support intervention to aid self-management – telephone follow up – in maintaining the health benefits for people who had participated in the Diabetes Prevention Project.
Participants were randomised to either a telephone support and self-care information (intervention group), or a self-care information only (control group).
Telephone support focussed on the project intervention goals and the participants’ own eating habits and physical activity goals and how well the patient was achieving or maintaining those goals. Participants were phoned a total of 12 times.
After 18 months, data were collected by a self-administered questionnaire and clinical and physical measurements taken from a total of 169 participants. The outcomes of primary interest were the biochemical and physical measurements – weight, waist circumference, blood pressure, total cholesterol, LDL, HDL, triglycerides, fasting glucose and oral glucose tolerance test – at 18 months after the original 12-month intervention, as well as adherence to self-care management guidelines, including diet and physical activity recommendations. A secondary analysis examined differences between intervention (self-care guidelines + telephone counselling)
Hospital Admission Reduction Program (HARP) (Evidence-Based Best Practice Model Clinical Pathways for People with Diabetes)
This project quantified hospital and other medical service utilisation for diabetes and diabetes complications and audited the associated diabetes management systems against recommended models. It also identified the psychosocial risk factors of depression and social isolation; systems barriers and enablers to optimum diabetes management and causes of preventable hospital admission for complications of diabetes.
PEACH: Patient Engagement and Coaching for Health: An Intensive Treatment Intervention for Patients with Type 2 Diabetes in Disadvantaged Communities
This study used a randomised controlled intervention to trial the use of practice nurses as ‘coaches’ to empower patients with type 2 diabetes to self-manage their condition and to more actively engage with their GPs in managing their condition.
Type 2 Diabetes and Depression: Assessing the Prevalence in Victoria and Identifying Effective Public Health Interventions
This project examined the extent of co-morbid depression (including depressive symptoms and disorders) among people with type 2 diabetes in ten General Practices throughout Victoria, and then made recommendations around the most effective public health interventions for the early detection and treatment of co-morbid depression among people with type 2 diabetes.