Comparison of different stepwise screening strategies for type 2 diabetes: Finding from Danish general practice, Addition-DK

Prim Care Diabetes. 2010 Dec;4(4):223-9. doi: 10.1016/j.pcd.2010.06.003. Epub 2010 Aug 1.

Abstract

Aim: To examine attendance, number of people with T2DM and costs of three different stepwise screening strategies for T2DM in general practice (GP).

Methods: Diabetes risk questionnaires were mailed to individuals aged 40-69 years from 45 general practices in 2001-2002 and individuals at high risk for T2DM, were asked to contact their GP to arrange a screening test. In 2005-2006, 26 general practices were randomised into two different opportunistic screening programmes (OP-direct and OP-subsequent) and risk questionnaires were distributed to individuals aged 40-69 years during GP consultations. In the OP-direct approach, high-risk individuals were offered to start the screening during the actual consultation while high-risk individuals in the OP-subsequent approach, were invited to a screening test at a later date. We report attendance, number of people with T2DM and costs of each screening approach.

Results: The mail-distributed approach identified 0.8% of the target population with T2DM, the OP-direct approach and the OP-subsequent approach, 0.9% and 0.5% respectively. Cost per person with T2DM was in the mail-distributed approach: € 1058, OP-direct approach: € 707 and the OP-subsequent approach: € 727.

Conclusion: This study indicates that opportunistic screening identifies the same level of unknown diabetes as a mail-distributed approach but with lower costs.

Trial registration: ClinicalTrials.gov NCT00237549.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Appointments and Schedules*
  • Biomarkers / blood
  • Blood Glucose / analysis
  • Chi-Square Distribution
  • Cost Savings
  • Denmark
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diagnosis*
  • Diabetes Mellitus, Type 2 / economics
  • Female
  • General Practice* / economics
  • Glucose Tolerance Test* / economics
  • Glycated Hemoglobin / metabolism
  • Health Care Costs
  • Humans
  • Male
  • Mass Screening / economics
  • Mass Screening / methods*
  • Middle Aged
  • Predictive Value of Tests
  • Referral and Consultation* / economics
  • Risk Assessment
  • Risk Factors
  • Surveys and Questionnaires* / economics

Substances

  • Biomarkers
  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human

Associated data

  • ClinicalTrials.gov/NCT00237549