DAP+: Transforming Diabetes Care in Regional Communities
DAP+ Moree event May 2023
Accessing optimal diabetes care within the vast Hunter New England Local Health District (HNELHD) can be a challenge. Covering an area equivalent to the size of the United Kingdom and serving nearly one million residents, the Health District faces unique geographical obstacles.
Diabetes poses a significant public health challenge in Australia, silently claiming lives. One in ten Australians have diabetes, and in the Hunter New England area, the prevalence is even higher, affecting one in eight individuals. Alarmingly, regional, remote, and First Nations communities face a 50% higher risk of undiagnosed diabetes, leading to severe complications and hospitalizations.
Recognising the need for comprehensive diabetes care, Associate Professor Acharya championed the creation of the Diabetes Alliance Program (DAP). His strong belief in equitable, high-quality care for all individuals with diabetes in HNELHD, regardless of their location, socioeconomic circumstances, or current health status, drove this initiative.
"Our goal is to develop a model of care for diabetes that can be applied to other chronic health conditions, fostering healthier and more innovative regional, rural, and remote communities," shared Associate Professor Acharya.
DAP+ Clinical Lead Associate Professor Sham Acharya
Before the introduction of DAP, individuals living with diabetes in regional and remote areas relied solely on their local general practitioners and community health services or had to travel to metropolitan centers for care.
In 2014, DAP commenced as a partnership between HNELHD and the Hunter New England and Central Coast Primary Health Network (PHN). The program transitioned from a pilot phase in 2015 to a full-fledged program in 2017.
In 2022, the Colonial Foundation generously contributed $12.4 million over five years to support HMRI and the DAP+ initiative. This significant gift empowers HMRI and its program partners, including Hunter New England Local Health District, the University of Newcastle, and the Hunter Central Coast Primary Health Network, to drive impactful changes in diabetes care.
With this new funding, DAP+ can implement and evaluate an innovative model of care. The program focuses on improving patient access to specialist services, resources, and training, empowering communities to effectively manage diabetes. The benefits of this program are particularly crucial for regional and rural communities, which often face challenges in accessing the same level of healthcare available in metropolitan areas. Additionally, the funding includes support for a specially designed "medibus" to reach the most distant communities in the local health district, including First Nations communities.
In May, five years after its initial visit, the DAP+ team returned to Moree. This visit aimed to build upon clinician-focused activities and expand community awareness about the impact of diabetes, often referred to as the "silent killer."
Yarn Bombing session in Moree
Why Moree?
Associate Professor Acharya explained, "Research has shown that 7% of the population in the Moree Plains Shire Council area lives with diabetes, making it the third leading, potentially preventable hospitalization condition in the region."
Moree also has a significantly higher proportion of Aboriginal and Torres Strait Islander residents compared to the rest of New South Wales (26.6% versus 3.4%). Ensuring access to necessary care and prevention treatments for this community is one of the primary objectives of DAP+.
Associate Professor Acharya shared exciting findings from their analysis: "Not only did patients who participated in our model experience improved outcomes, but there was also a significant 'spill over' effect. The knowledge gained during the diabetes alliance intervention positively impacted the broader patient population. For example, in our analysis of 72 practices, for every 1,000 case conferences conducted, we observed improvements in diabetes-related illnesses among 22,000 patients."
During the week-long visit to Moree, the DAP+ team engaged with community leaders, local residents, clinicians, and general practitioners. Their interactions were marked by generosity, as individuals shared their personal stories and experiences with diabetes. One such individual, Lyndon Hankey, a 38-year-old creative, participated in the Yarn Bombing Project, a crochet workshop where diabetes was discussed alongside creative endeavours.
"After being diagnosed with diabetes last March, my life changed. I've always been aware of it; as a child, I would flick my nan's needle to check for bubbles," shared Mr. Hankey. Reflecting on the DAP+ team's visit, he emphasized the importance of specialists reaching out to small country towns, where access to specialized care is often challenging due to urban concentration.
Other events organized by DAP+ included a diabetes educational expo, two council employee information breakfasts, a clinician evening, and a collaborative walk-and-talk event with the town's weekly parkrun.
In the coming months, the DAP+ team will continue traveling to regional towns within the Hunter New England Local Health District footprint, working diligently to educate communities and medical professionals about diabetes, the region's silent killer.
DAP+ is a partnership involving Hunter New England Local Health District's Diabetes Alliance Team, the Hunter New England Central Coast Primary Health Network (PHN), Hunter Medical Research Institute (HMRI), and the University of Newcastle (UoN). Through their collective efforts, DAP+ is reshaping diabetes care and empowering regional communities to tackle this pervasive health challenge head-on.