Background
Rockingham is located about 40 kilometres from Perth, There are 1178 patients with Type 1 Diabetes in Princess Margaret Hospital (PMH). The PMH-Rockingham clinic comprises 152 patients who reside in the designated catchment area.
The diabetes clinics have been located in the same building since 2010. Joint appointments are held between adult and paediatric teams. Adolescents and parents observe and participate in a clinical handover. The first adult appointment is made prior to leaving the paediatric clinic to facilitate transition.
Evaluation of retention and glycaemic control over a 5-years following co-location of services and institution of joint appointments
Method:
Patients transferred from PMH to Rockingham between 2010 and 2015 were ascertained from the Diabetes Paediatric Management System. HbA1C at the time of transition and mean HbA1C from diagnosis were compared with HbA1C at 1 and 2 years from transition.
Successful transition was defined as a gap of < 6 months between paediatric and adult clinic and 2 or more presentations per year for 2 years following transition to adult TIDM service
Statistical data is described using frequencies and proportions for Categorical data, means and standard deviations for continuous data.
HbA1c was compared using a linear mixed model which accounts for correlation between time points. Time was entered as a variable and pairwise comparisons were produced. All data was analysed using Stata 14.1 (StataCorp, College Station, TX). Statistical significance was considered p<0.05.
Results:
Mean age at transition was 17.7 years ± 0.8 years, 90% were present in the adult service 12 month from transition and 84% were remained at 24 months. Mean HbA1C at transition was 9.44 % and improved to 9.14 % over the subsequent 2 years.
Conclusion:
Joint appointments improved continuity of care. Co-location of services contributed to higher success of transition and retention over 2 years.