Background: The Baker IDI Central Australia Diabetes Outreach Service is a multidisciplinary, specialist-led outreach service delivered by visiting endocrinologists, and diabetes nurse educators (DNEs) based at Baker IDI in Alice Springs. It aims to support better diabetes care in the Central Australia by augmenting health services currently in place in ten remote Aboriginal communities. An evaluation was undertaken to assess service activity, access and clinical effectiveness.
Methods: Three communities with health services managed by the NT government were selected for review. A retrospective audit of the electronic health records (PCIS) of patients reviewed by the Service between April 2011 and April 2014 was undertaken. Data collected related to patient contacts, test results, and medications at baseline 6 months and 12 months following commencement of the service.
Results: 124 patients were included in the review. The median age was 48.6 years and 95 (77%) were female. 243 onsite consultations were provided by endocrinologists (usually in partnership with a DNE) while 298 consultations were provided by DNEs alone. Median (IQR) HbA1c results at baseline, 6 months and 12 months were 10.3% (8.1 – 11.8), 9.0% (7.6 – 11.1), and 9.6% (7.6 – 11.2), respectively. There were significant differences between HbA1c results at baseline and 6 months (z=-3.183, p=0.001) and between baseline and 12 months (z=-3.144, p=0.002). At 6 months 68% of patients had a reduction in cholesterol levels, 61% had a reduction in LDL, 61% had reduced triglycerides, 50% had reduced ACR levels, and 50% of patients had reduced blood pressure. Weight loss was recorded for 40% of patients at 6 months and 56% at 12 months.
Conclusions: The Baker IDI Central Australia Diabetes Outreach Service to over 100 patients in remote communities was associated with improved outcomes for glycaemic control, markers of renal and cardiovascular disease.