Rotorua Area Primary Health Services (RAPHS) holds two current contracts for diabetes care and management in the Rotorua district: Diabetes Annual Review (DAR) and Retinal Screening.
Diabetes programmes
More than 2000 people with diabetes are enrolled at RAPHS member’s general practices, and the number of people in the area diagnosed with the condition increased by 63% between 2001 and 2007.
Overall, the prevalence of diabetes in the RAPHS area (which includes Murupara) has increased from 3.36% to 3.7% during 2007, with the rise evident across all ethnic groups.
In 2007, 83% of our eligible patients had had a DAR, and practices are more than keeping up with diabetes management for the growing number of patients diagnosed with this condition. RAPHS also participates fully in the Lakes Local Diabetes Team.
Key contacts:
- Jane, RAPHS Clinical Manager, Director of Nursing and Lakes Diabetes Team Chairwoman
- Dr Mike Williams, RAPHS Clinical Leader for Diabetes
- Dr Nic Crook, Diabetologist
- Lakeland Health Diabetes Educators and Dieticians
Free Diabetes Annual Review
All people diagnosed with type 1 or type 2 diabetes are eligible to receive a free annual diabetes annual review (DAR).
As diabetes is a chronic, incurable condition, most of those eligible to enter the DAR programme remain on it indefinitely. Even those people who receive most of their care from specialists remain eligible to receive this service.
Generally, results have been encouraging. The proportion of patients with a DAR whose HBA1c is 7 or below was 43% in 2007, compared with 37% in 2003.
The trend for Maori patients, however is not pleasing. The proportion of Maori with a HBA1c of 7 or below has risen from 25% in 2004 to 32% in 2007.
The annual reviews have revealed other health trends among participating diabetes patients:
- Those who smoke fell from 23% in 2003 to 15% in 2007.
- Those on a statin rose from 41% in 2003 to 61% in 2007
- Those on an ACE inhibitor rose from 55% in 2004 to 58.5% in 2007
- Those on aspirin rose from 18% in 2003 to 60% in 2007
Rotorua Area Primary Health Services is contracted by Lakes District Health Board (for Rotorua) and Bay of Plenty District Health Board (for Murupara) to provide this programme.
Retinal Screening
This service screens every person with known diabetes for the onset of clinically significant diabetic retinopathy and refers those at risk of visual impairment for diagnosis and treatment by ophthalmologists before avoidable loss of vision occurs. Primary care teams, often after a Diabetes Annual Review, or specialists (also notifying the primary care team) may refer people into the service.
The service is undertaken by SpecSavers and the Visique McClelland Optometrists. Wheelchair users will require examination by direct ophthalmoscope rather than the diabetic retinal photoscreening camera, and will be need to be directed to the appropriate optometrist.
Rotorua Area Primary Health Services is contracted by Lakes District Health Board to provide this programme.
The future
RAPHS is building on the current high level of care and enthusiasm for assisting people to manage diabetes. This includes:
- Working with community groups to try to reduce/contain the increasing incidence of diabetes (e.g. healthy living, healthy eating programmes at school canteens etc)
- Implementing a project to assist practices with patients who do not attend Diabetes Annual Review
- Building better relationships between community, primary care and secondary care to improve the delivery of care to those with a known diagnosis of diabetes.