Evaluating the impact of the Piki te Ora extended primary care team on clinical outcomes in type 2 diabetes patients: a retrospective study
Sara Mustafa
1 * , Claire Cannon 2 , Rawiri Keenan 1 3 , Martin Mikaere 2 , Tammy Dehar 2 , Suzanne Moorhouse 4 , Janine Thompson 2 , Lynne Chepulis 1
1
2
3
4
Abstract
Type 2 diabetes (T2D) is a significant health issue in New Zealand with a disproportionate effect for Māori. To address inequities and optimise care, Te Korowai Hauora o Hauraki, an Iwi Māori health provider, established the ‘Piki te Ora service’ to support its five rural clinics by providing culturally safe, multidisciplinary support for patients with T2D.
This study aimed to undertake a service review, describing and evaluating the available clinical data, of the Piki te Ora service.
Patients enrolled in the Piki te Ora service between January 2021 and March 2024 were invited to have their data (sociodemographic, HbA1c, cholesterol and blood pressure) included in the review. Frequency and mode of health care/patient contact were also explored.
A total of 112 patients were contacted and 64 (mean age 58 years, 62.5% Māori) consented to data review. Over 6 months, patients in the Piki te Ora service were contacted an average of 9.5 times, with phone calls being the predominant mode of contact. Median HbA1c levels significantly decreased by 16.0 mmol/mol at 6 months post enrolment in the Piki te Ora service (P = 0.011) but no significant changes were observed in cholesterol or blood pressure.
The Piki te Ora service appears to provide effective support for T2D management, particularly glycaemic control, however more clinical data is needed to evaluate its effectiveness. Its flexible and accessible approach, including free consultations, may enhance care accessibility, especially for economically deprived patients.
Keywords: type 2 diabetes, health equity, multidisciplinary care team, patient-centred care, chronic disease management, health service delivery, primary health care, New Zealand.
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