HANNAH WALLACE1,2,3, DR CHRISTOPHER PRESTON1,2, QIUMIAN WANG1, DR NATALIE LUMSDEN1,2, DR BARBARA HUNTER2, DR OLIVER DALY2, A/PROF MIN JUN3,4, DR DEV KEVAT1,2, A/PROF CRAIG NELSON1,2
1Western Health Chronic Disease Alliance, Melbourne, Australia , 2Department of Medicine Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia , 3The George Institute for Global Health, Sydney, Australia, 4Faculty of Medicine and Health, UNSW, Sydney, Australia
Biography:
Dr Hannah Wallace is a nephrologist at Western Health in Melbourne. She is a PhD candidate at Melbourne University and The George Institute for Global Health, with her research focus on understanding current patterns of chronic kidney disease care and exploring models to improve care. She has a keen interest in digital health and is a honorary clinical fellow with the Centre for Digital Transformation of Health, University of Melbourne.
Aim:
To evaluate the prevalence of diabetes (DM), chronic kidney disease (CKD) and cardiovascular disease (CVD) in primary care practices participating in the Future Health Today implementation trial in Melbourne’s West.
Background:
Future Health Today (FHT) is a clinical decision support and quality improvement software used to aid testing, diagnosis and management of DM, CKD and CVD. An implementation trial is underway to explore the effectiveness of a program using FHT to improve chronic disease management in primary care.
Methods:
FHT Implementation Trial is a pre-post implementation trial in primary care practices in the Western Health catchment of Victoria. We assessed the baseline characteristics of adults (>18 years) who were active patients (defined as 3 visits within 24 months) at one of the 19 participating practices on 1 August 2024. Age-standardised prevalence was calculated using the 2021 Australian census data.
Results:
There were 80,325 active adult patients with 57.5% being female and a mean age of 47.4 years (SD 17.8). The age-standardised prevalence of >1 cardio-kidney-metabolic condition was 16.5 per 100 people (95% CI 16.2-16.8), with diabetes 11.2 (95% CI 11.0-11.5), kidney disease 5.4 (95% CI 5.2-5.5) and cardiovascular disease 5.3 (95% CI 5.1-5.4). Additionally, a further 19.0% of patients had obesity, hypertension or pre-diabetes. There is likely further undiagnosed disease with 33.1% at high-risk for diabetes and 43.4% at risk for CKD. Of those at risk, 66.1% had a diabetes screening test within recommended time frames and 22.6% had a kidney health check (all of eGFR, UACR and blood pressure) within the previous 24 months.
Conclusion:
We report a high prevalence of cardio-kidney-metabolic disease in Melbourne’s West despite under-testing in high-risk groups.
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