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       #Post#: 164--------------------------------------------------
       How to reduce risk of developing long term complication of diabe
       tes?
       By: admini5 Date: May 13, 2015, 5:47 am
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       To develop a systematic approach to improving the outcomes of
       people with diabetes by reducing their cardio-metabolic risk. By
       improving the outcomes of care delivered within primary care,
       the programme aimed to reduce admission rates to hospital.
       In 2008, people with diabetes living in Greenwich had some of
       the poorest outcomes in the country as measured through Quality
       Outcomes Framework (QOF) achievement rates. Only 53.7% of
       patients with diabetes had an HbA1c <7.5% (DM20), which was in
       the bottom 1% of PCTs. 76.7% of patients with diabetes had a
       cholesterol level of <5 mmol/L (DM17), which was also in the
       bottom 1% of PCTs. 76.9% of patients with diabetes had a blood
       pressure of <145/85 mmHg (DM12), which was in the bottom 14% of
       PCTs. As a result, a new initiative was launched to develop a
       more systematic approach to secondary prevention in primary
       care. As part of this initiative NHS Greenwich joined a
       partnership with MSD (UK subsidiary of Merck) to deliver
       improvements using the established EVIDENCE into PRACTICETM
       programme, which provided assisted, structured cardio-metabolic
       risk management and supported sharing of best practice and
       continuing professional development. This programme &#8216;aims
       to ensure that people with diabetes and those at increased
       cardio-metabolic risk receive optimal care through the effective
       implementation of national policy and guidelines, particularly
       NICE Type 2 Diabetes Guidelines&#8217; (NICE 2009, see contacts
       and resources).The programme was designed to improve health
       outcomes of people with diabetes through the implementation of
       national and/or local guidelines. An additional aim is to ensure
       that the practices are self-sustaining in the future.
       The service objectives were:
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       general practice in order to improve secondary prevention
       outcomes, including blood pressure, HbA1c and cholesterol
       management.
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       identifying pre-diabetes, managing patient-centred plans and
       reviews, educating patients about self-management and any other
       aspects of diabetes care.
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       NHS and Social Care Long Term Conditions Model' (Department of
       Health 2005).
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       obesity, cardio-metabolic risk and established disease including
       diabetes, occlusive arterial disease and chronic kidney disease.
       -
       -
       what needs improvement.
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       clinical behaviour and interventions.
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       example, people with diabetes and occlusive arterial disease
       with increased cardio-metabolic risk factors.
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       benefit from a structured lifestyle intervention and
       cardio-metabolic risk reduction programme.
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       behaviour and service provision to improve outcomes.
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       knowledge and potential training needs.
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       The pilot practices were selected according to a number of
       criteria, including prevalence rates of coronary heart disease,
       diabetes registers and deprivation rates. Practices were
       included if they had a diabetes prevalence that was higher than
       the national average, a coronary heart disease prevalence that
       was higher than the national average and/or an index of multiple
       deprivation score that was higher than the national average.
       For further detailed information, visit:
  HTML https://arms.evidence.nhs.uk/resources/qipp/899089/attachment
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