Achieving GP diabetes targets could boost health and cut costs
Author: Adrian O'Dowd
Significant gains in life expectancy and healthcare cost savings could be achieved if all GP practices met official diabetes treatment targets, suggests a new study* published in the journal Diabetes, Obesity and Metabolism.
Researchers from the Nuffield Department of Population Health at the University of Oxford assessed the long-term impact of achieving treatment targets for type 2 diabetes on diabetes-related complications, life expectancy, and healthcare costs.
Diabetes affects 9% of the UK adult population, and the condition is associated with increased risk of complications such as heart disease or stroke.
An estimated £10bn, approximately 10% of the NHS budget, is spent on diabetes annually and 80% of this cost is for treatment of diabetes complications.
GP practices are encouraged to achieve defined treatment targets for blood glucose, blood pressure and cholesterol, as set by the National Institute for Health and Care Excellence.
The National Diabetes Audit (NDA), which measures the effectiveness of diabetes healthcare, has recently reported improvements in achieving defined treatment targets for blood glucose, blood pressure, and cholesterol among people with type 2 diabetes.
However, the percentage of patients who achieve all three targets is relatively low, ranging from 27% to 54% across groups of GP practices in England and Wales.
For their study, the researchers used characteristics of type 2 diabetic patients from the 2015–2016 NDA to generate representative populations of such patients.
Using an outcomes model, they estimated what the effects of achieving the official treatment targets would be on patients’ long‐term health outcomes and healthcare costs.
The research showed that meeting treatment targets lowered people’s risk of diabetes-related complications, which would then lead to significant savings and help people with diabetes live longer, healthier lives.
It suggested that meeting the three targets could reduce the cost of treating complications by £1,037 per patient over 10 years, but it should be noted these savings did not factor in the potential costs involved in helping people to meet additional treatment targets.
NHS England could save £727m over 10 years if all people with type 2 diabetes over the age of 20 in England and Wales met their three target treatments, they calculated.
Mi Jun Keng, researcher at the Nuffield Department of Population Health and lead author of the paper, said: “Our study found that meeting more treatment targets was associated with lower risk of a range of diabetes-related complications. Patients would live on average seven months more for each additional treatment target achieved.”
Professor Borislava Mihaylova, senior author of the paper said: “Our study shows that if the 10% lowest performing GP practices (with about a quarter of their patients meeting the targets) were to reach the target levels achieved by the top 10% performing GP practices (with about half of patients meeting the targets), they would realise an average gain of 30 years of life for every 100 patients or 3.6 months per patient.
“These benefits would more than double if they could get all their patients to meet all three treatment targets.”
Nikki Joule, policy manager at Diabetes UK, which partly funded the study, said: “We hope these findings categorically demonstrate to healthcare commissioners that there are significant economic benefits in improving the support people with type 2 diabetes receive to help them manage their condition.
“It’s vital that all people with diabetes are given the support they need to meet as many of their treatment targets as possible. This will help people with diabetes live longer, healthier lives and could also save money for our already stretched NHS.”
*Keng M J, Tsiachristas A, Leal J, et al. Impact of achieving primary care targets in type 2 diabetes on health outcomes and healthcare costs. Diabetes Obes Metab. 2019; 1– 8. DOI:10.1111/dom.13821