Diabetic nephropathy is the most common cause of chronic kidney failure. Capital Health is working with its partners to reverse that trend.
Diabetic nephropathy is a complication of diabetes. For individuals who have this condition, their kidneys lose their ability to function properly, which is the leading cause of end-stage renal disease (ESRD). Treatment of ESRD by renal replacement therapy, e.g. dialysis, is costly and time-consuming. Early intervention can prevent or delay the advance of diabetic kidney disease.
In December of 2003, Capital Health, David Thompson, East Central, and Aspen health regions launched a one-year, $1.2 million pilot project to help reduce the incidence of ESRD. The pilot, funded by the Alberta Government, will see community-based teams established in five communities: the sites were chosen in collaboration to address regional needs.
“If it wasn’t for this clinic, I’m pretty sure that my condition would have continued to deteriorate,” says diabetes and cardiac patient Warren Bittorf. “They sat down with me and worked through my symptoms and my medications step by step as a multidisciplinary team, including my family doctor, until they came up with some solutions for me. It’s provided me with hope and improved my quality of life substantially.”
“We’re thrilled with this new initiative and the opportunity it brings to strengthen our relationships with other health regions,” says Neil Wilkinson, Capital Health Board Chair. “Moving services into the community, especially when managing chronic diseases, is less disruptive to patients and results in a better quality of life.”
The goal of the pilot project is to identify and treat patients with diabetes who may be at risk of developing renal disease. The interventions aim to reduce blood pressure, improve blood glucose control and reduce cardiovascular risk factors (such as blood cholesterol and smoking). These preventative measures will improve overall health, reduce heart attacks and strokes, and reduce the number of patients who ultimately require renal replacement therapy. The primary focus is to improve quality of life for people who have diabetes and to reduce demand on healthcare resources.
“Given the characteristics of diabetic nephropathy, we’re able to identify people who are at risk of developing the condition,” says Laurel MacNair, Project Manager, Diabetic Nephropathy Clinics, Northern Alberta Renal Program. “This project also represents a way to enhance quality of life for many people with diabetes. It means shifting the focus from the treatment of an avoidable condition to its prevention.”
The teams, consisting of a nurse and a dietician, will be located in Red Deer and Wetaskiwin in the David Thompson Health Region area, in the Hinton/Edson/Jasper corridor in Aspen Health Region, in Vermilion in East Central Health and in Edmonton at the Northeast Community Health Centre. The two on-site staff members in each clinic will be assisted by a centrally based social worker, pharmacist, clerk and project manager as well as two specialist physicians from Edmonton who will make clinic visits twice a year.
“These clinics are being received very positively by our patients,” says Dr. Charles Duvenage, Site Chief at the Vermilion Health Centre (operated by East Central Health). “They’re able to attend their appointments, receive the care they need and they don’t need to leave their community.”
The clinics will accept referrals from and work in partnership with family physicians, focusing on diabetic patients with high blood pressure or protein in their urine, for participation in the pilot project. Each clinic will be tailored to the community they serve, working with local general practitioners, public health and home care nurses to provide the information and services required.
“Diabetes affects the lives of thousands of Albertans annually,” says Gary Mar, Minister, Alberta Health and Wellness. “I am very pleased with the work that is being done because of the positive impact that it will have on so many Albertans.”
This project is a primary health care initiative of the Northern Alberta Renal Program and Capital Health. The launch of this pilot project is part of Capital Health’s Primary Health Care strategy which was created to guide all initiatives developed over the next several years. For more information on primary health care in the region, see “Primary Health Care Strategy – Better Health and Better Health Care” on the Capital Health website at www.capitalhealth.ca.