RT Journal Article
SR Electronic
T1 Randomised controlled trial of near-patient testing for glycated haemoglobin in people with type 2 diabetes mellitus
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP 511
OP 517
VO 56
IS 528
A1 Kamlesh Khunti
A1 Margaret A Stone
A1 Andrew C Burden
A1 David Turner
A1 Neil T Raymond
A1 Mary Burden
A1 Richard Baker
YR 2006
UL http://bjgp.org/content/56/528/511.abstract
AB Background Tight glycaemic control in people with type 2 diabetes can lead to a reduction in microvascular and possibly macrovascular complications. The use of near-patient (rapid) testing offers a potential method to improve glycaemic control.Aim To assess the effect and costs of rapid testing for glycated haemoglobin (HbA1c) in people with type 2 diabetes.Design of study Pragmatic open randomised controlled trial.Setting Eight practices in Leicestershire, UK.Method Patients were randomised to receive instant results for HbA1c or to routine care. The principal outcome measure was the proportion of patients with an HbA1c <7% at 12 months. We also assessed costs for the two groups.Results Of the 681 patients recruited to the study 638 (94%) were included in the analysis. The mean age at baseline was 65.7 years (SD = 10.8 years) with a median (interquartile range) duration of diabetes of 4 (1–8) years. The proportion of patients with HbA1c <7% did not differ significantly between the intervention and control groups (37 versus 38%, odds ratio 0.95 [95% confidence interval = 0.69 to 1.31]) at 12 months follow up. The total cost for diabetesrelated care was £390 per patient for the control group and £370 for the intervention group. This difference was not statistically significant.Conclusion Near-patient testing for HbA1c alone does not lead to outcome or cost benefits in managing people with type 2 diabetes in primary care. Further research is required into the use of rapid testing as part of an optimised patient management model including arrangements for patient review and testing.