Frontline fighting: tackling diabetes through primary health care in rural and regional South Australia

Diabetes is a growing challenge facing communities all over Australia. According to Diabetes Australia, it is the nation’s fastest growing chronic condition with 280 people developing the disease every day. 

In South Australia, 5.6 per cent of the population is estimated to have diabetes – which is slightly higher than the national average. In country South Australia, diabetes complications accounted for 1,236 potentially preventable hospital admissions in 2014-2015, a small increase compared to the year before.

“It’s a sad reality that diabetes is a growing problem facing communities all over Australia and particularly so for many regional and rural communities,” said Country SA PHN CEO Kim Hosking.

“In fact, diabetes related lower limb amputation rates have worsened in Australia in the last 20 years and, in 2015, the rate for South Australia was 40 per 100,000 population.”

“When you share this type of information with people outside of the health industry, the initial reaction is often one of shock – there’s an expectation that these figures should be declining rather than increasing.”

Country SA PHN recently formed a partnership with the Country Health SA Local Health Network (CHSALHN) to deliver a diabetes management education program. The program is designed to reinvigorate primary health care as a key component in tackling diabetes.

“We know that 30 per cent of people with chronic disease are being managed in general practice so it’s vital that these patients are being given the right advice to help them achieve the best long-term health outcomes,” Kim said.  

“Primary health care nurses in particular have a very important role to play in team-based care processes, including motivational interviewing, education activities and support for lifestyle modification of people with type 2 diabetes.”

“Together with CHSALHN, we have developed an education package for rural primary health care nurses to support them in caring for diabetes patients at any point on the care continuum – from diagnosis to amputation.”

“Overall, we hope to achieve a well-integrated system that is better equipped to help patients better manage their condition.”

Importantly, the program is also about enhancing nurses’ confidence and capacity.

“These nurses really are at the frontline when it comes to helping patients self-manage their condition so it’s critical we arm them with the skills and knowledge to do this effectively,” Kim said.

“The benefit is two-fold – not only does it deliver a better result for the patients themselves, but it will also reduce pressure on tertiary services, freeing up valuable time and resources which can be allocated to other conditions.”

To date, workshops have been held in three regions including the Clare Valley, Port Pirie and Port Augusta. Feedback from the primary health care nurses who attended was overwhelmingly positive, particularly about new or refreshed skills they will be able to implement during their day-to-day practice.

Furthermore, since the workshops were completed, CHSALHN has reported increased communication between the primary health care nurses and the diabetes nurse educator within the regions – a clear example of how the program is already improving integration of the health system which will, in turn, help to improve the patient journey and experience.

“We’ll be rolling out additional education workshops in locations across regional and rural South Australia this year and are continuing to work with CHSALHN to look how we can further the important work of this program,” Kim said.