Background

The Australian National Diabetes Audit – Australian Quality Self Management Audit (ANDA-AQSMA) is an important biennial quality improvement activity led by the National Association of Diabetes Centres (NADC), carried out in many diabetes centres across Australia. Participating specialist diabetes services receive an individualized report of their diabetes practice processes and patient outcome data benchmarked with the outcome of other centres across the country. In addition, the pooled national report is an important source of cross- sectional data on the clinical status and outcomes of individuals attending specialist diabetes services across the country during the audit period.

Methods

Volunteer centres conducted the ANDA-AQSMA 2014 survey of all consecutive patients attending their service over a 4week period, during the month or May or June 2014. Doubly de-identified data was collated and processed at the ANDA central coordinating/reporting centre based at Monash Health Diabetes Unit, Victoria. Information collected included patient demographics, type of diabetes, management methods, glycemic control, smoking status, medication use, health professional attendances, self care practices, assessment and management of depression (using the Brief Case Find For Depression). Quality of life was assessed using a Self Assessment of Health Status form. If a patient scored greater than 3 on screening, they were required to complete the Diabetes Distress Scale 17(DSS17) form.  Data analysis and reporting included descriptive statistics, by site, year of collection and location.

Results

Data for 2681 patients from 38 Diabetes Centres was collected. All states and territories were represented. The mean age of participants was 55 (± 17.5) years with males and females being equally represented. Most patients had T2DM (67%). The mean (±SD) HBA1c of all patients was 8.2%(±1.8). With respect to lifestyle management, 54% reported not engaging in sufficient physical activity. 13% were current smokers with 76% having tried to quit. 30% had difficulty following a prescribed diet yet only 51% had seen a dietitian. Looking at wellbeing, 29% were likely depressed with 34% on antidepressants and 20% seeing either a psychologist or psychiatrist. In regard to self- management, 40% reported some non- compliance with medications and 25% were not monitoring blood glucose levels as recommended.

Conclusions

The Australian National Diabetes Audit – Australian Quality Self Management Audit 2014 reveals considerable reduced wellbeing and diabetes related distress in patients attending the Diabetes Centres. This demonstrates a need for psychological support and ongoing education on lifestyle measures.