The PRISM Study - Pharmacy based screening of high risk individuals using stepwise methods

Principal Investigators: Professor Kamlesh Khunti and Professor Melanie Davies

Other key staff: Dr Margaret Stone, Dr Laura Gray, Dr Helen Eborall, Mr Stephen Hiles, Mr Bill O’Leary, Mr Andrew Willis

Partners involved: NHS Leicester City, NHS Leicestershire County and Rutland, NHS Northamptonshire

Summary: The department of health recently introduced a ‘vascular checks’ programme, to offer screening to all aged 40-74 years to identify those at risk or suffering from cardiovascular disease and related diseases such as type 2 diabetes mellitus (T2DM). Despite no clear guidance on which method should be used to identify those at high risk of diabetes it is clear that invasive screening procedures are expensive and time consuming. Risk scores are one way of filtering out people at a lower risk and focusing more costly screening methods on high risk individuals.

This study is a pragmatic randomised trial aiming to recruit 2,406 participants from Leicester City and Northamptonshire pharmacies. We will assess the efficacy of two screening methods for opportunistically screening individuals for T2DM.

Aims:

• To test the effect of pharmacy screening using a self assessed risk score followed by near patient HbA1c testing in pharmacies or general practices on levels of uptake of a second stage blood test (OGTT) conducted at the GP surgery compared to screening with a risk score alone
• To assess the patient, pharmacist and general practitioner acceptability of two different screening methods for impaired glucose regulation (IGR) and T2DM

Further information: If you would like to be involved in this project please contact This e-mail address is being protected from spambots. You need JavaScript enabled to view it , Early Detection Theme Manager

Start date: 09/2010                                                                                                      Expected end date: 03/2012

Study outcomes:

• The primary outcome is uptake of high risk individuals to an OGTT test at the GP
• The secondary outcomes include; patient, pharmacist and practitioner views, yield in positive tests for T2DM and IGR, proportion of patients who have had a diabetes screening test in the previous 12 months and association between illness perception and uptake to the final confirmatory test

The project outcomes may show positive clinical and economic benefits of engaging individuals at high risk of type 2 diabetes mellitus in a pharmacy setting.