The diabetes annual review as an educational tool: assessment and learning integrated with care, screening, and audit. The North Tyneside Diabetes Team.

An integrated diabetes Annual Review is described, suitable for the long-term care of large numbers of diabetic patients. Equal weight is given to dietary and educational assessment as to medical care and screening. Based on well-developed team-work the patient moves through a structured review which culminates in goal setting and planned care for the subsequent year. A structured audit of the review was carried out on a cohort of 123 patients of whom 67 had had two annual reviews. Ten patients failed to attend. Knowledge scores improved by 44% between first and second reviews. In 34% of patients in the first year and in 46% in year two, HbA1c levels were outside a target range set for each treatment group, but only 18% had results outside target in both years. A postal questionnaire was returned by 74/108 (69%) patients. This indicated a high level of patient participation and satisfaction with the review process. The diabetes team set standards, conducted the review, and subsequently changed in-house working practices and documentation, and developed in-service training.