An Evaluation of a Diabetes 'Shared Care' Program in a Rural Division of General Practice

Abstract

This article describes an evaluation of a diabetes 'shared care' program run in a rural Division of General Practice. A summative evaluation examined the extent to which the program had achieved its aim, which was to achieve reduced morbidity, improved health outcomes and better quality of life for participants. This involved examining routinely collected clinical data, interviewing randomly selected patients (n=23) about self-reported health outcomes, and interviewing 20 participating general practitioners (GPs) about their perceptions of the program's impact on their patients. The program appeared to achieve its aim. Clinical data were limited, but indicated that patients' self care had improved, as evidenced by weight loss. Approximately half reported improved blood glucose self monitoring and diet, and 17% reported increasing their exercise. Nine per cent felt more empowered to deal with health professionals. Over half the patients reported that their health status had improved. The majority of GPs were positive about the impact of the program on their patients. A formative evaluation provided information about program design. This information was elicited through patient and GP interviews. In terms of program design, respondents were positive, but indicated that certain issues required resolution: communication, role delineation and co-operation between the GPs and the diabetes educators. This evaluation provides some clear lessons for future Divisional projects. Such projects can produce health gains, but can be enhanced through a variety of measures ? for example, the use of protocols and guidelines concerning written and verbal communication.