BACKGROUND: A pilot programme designed to systematically screen for type 2 diabetes was introduced in 24 general practices in England selected for their high levels of socio-economic deprivation and multi-ethnic populations. OBJECTIVE: To evaluate the impact of screening on the prevalence of type 2 diabetes. METHODS: A prospective audit of screening activity in pilot practices and comparison of the change in prevalence of diabetes in pilot and comparison practices were conducted. RESULTS: Of 41,400 individuals invited for screening from a population of 165,828 in pilot practices, 25,356 (61%) were screened. Three hundred and fifty-eight (0.22%) new cases of diabetes were detected among those screened. Only 69% of those with a positive screening test had diagnostic testing recorded and only 19% had a record of an oral glucose tolerance test. The absolute increase in the prevalence of diagnosed diabetes was 0.53% in pilot practices and 0.42% in comparison practices. CONCLUSIONS: The 'real world' nature of the programme and dependence on routine data collection systems makes results more difficult to interpret but also enabled problems with implementation, not evident from previous research, to be identified. It is likely that the low diagnostic yield was largely due to a high level of ad hoc screening activity outside the pilot protocol and inadequate access to diagnostic testing after a positive screening test. In particular, implementation of screening for diabetes in primary care should not be undertaken without robust assessment of the resources required for diagnostic testing and follow-up and adequate clinical audit.
BACKGROUND: A pilot programme designed to systematically screen for type 2 diabetes was introduced in 24 general practices in England selected for their high levels of socio-economic deprivation and multi-ethnic populations. OBJECTIVE: To evaluate the impact of screening on the prevalence of type 2 diabetes. METHODS: A prospective audit of screening activity in pilot practices and comparison of the change in prevalence of diabetes in pilot and comparison practices were conducted. RESULTS: Of 41,400 individuals invited for screening from a population of 165,828 in pilot practices, 25,356 (61%) were screened. Three hundred and fifty-eight (0.22%) new cases of diabetes were detected among those screened. Only 69% of those with a positive screening test had diagnostic testing recorded and only 19% had a record of an oral glucose tolerance test. The absolute increase in the prevalence of diagnosed diabetes was 0.53% in pilot practices and 0.42% in comparison practices. CONCLUSIONS: The 'real world' nature of the programme and dependence on routine data collection systems makes results more difficult to interpret but also enabled problems with implementation, not evident from previous research, to be identified. It is likely that the low diagnostic yield was largely due to a high level of ad hoc screening activity outside the pilot protocol and inadequate access to diagnostic testing after a positive screening test. In particular, implementation of screening for diabetes in primary care should not be undertaken without robust assessment of the resources required for diagnostic testing and follow-up and adequate clinical audit.
Authors: Jonathan Graffy; Julie Grant; Kate Williams; Simon Cohn; Sara Macbay; Simon Griffin; Ann Louise Kinmonth Journal: Fam Pract Date: 2010-04-19 Impact factor: 2.267
Authors: D R Webb; K Khunti; B Srinivasan; L J Gray; N Taub; S Campbell; J Barnett; J Henson; S Hiles; A Farooqi; S J Griffin; N J Wareham; M J Davies Journal: Trials Date: 2010-02-19 Impact factor: 2.279
Authors: Theresa M Marteau; Eleanor Mann; A Toby Prevost; Joana C Vasconcelos; Ian Kellar; Simon Sanderson; Michael Parker; Simon Griffin; Stephen Sutton; Ann Louise Kinmonth Journal: BMJ Date: 2010-05-13
Authors: L A Sargeant; R K Simmons; R S Barling; R Butler; K M Williams; A T Prevost; A L Kinmonth; N J Wareham; S J Griffin Journal: Diabet Med Date: 2010-09 Impact factor: 4.359
Authors: Fernando Gomez-Peralta; Cristina Abreu; Leonor Andreu-Urioste; Ana Cristina Antolí; Carmen Rico-Fontsaré; David Martín-Fernández; Rosa Resina-Rufes; Juan Jesús Pérez-García; Ángela Negrete-Muñoz; Daniel Muñoz-Álvarez; Guillermo E Umpierrez Journal: Int J Emerg Med Date: 2016-02-19