The objectives were to address the global disease burden of diabetes and to use point-of-care testing (POCT) as a tool to improve access to key pathology tests used in diabetes care. Working with international university partners, the Centre has developed a POCT network for diabetes management called ACE (Analytical and Clinical Excellence) that enables POCT for hemoglobin A1c and urine albumin-creatinine ratio to be conducted in primary care settings with a strong emphasis on education, training, continuous quality improvement, and community engagement. The ACE program has commenced in 35 rural and remote primary care services in Canada, East Timor, Papua New Guinea, Samoa, Solomon Islands, South Africa, and Thailand. High levels of poor glycemic control were identified across all countries. In terms of renal function, approximately 40% of diabetes patients were identified as having microalbuminuria or macroalbuminuria. Results of quality testing indicate that the trained POCT operators in the ACE program have collectively demonstrated sound analytical performance for both hemoglobin A1c and urine albumin-creatinine ratio across all participating countries. Improved pathology service delivery through access to primary care-based POCT has built the capacity of rural and remote communities participating in the ACE program to sustain innovative, quality-assured POCT solutions and to help close the gap in health equity, particularly for diabetes care.
From the Flinders University International Centre for Point-of-Care Testing, Flinders University, Adelaide, South Australia, Australia.
Reprints: Lara A. Motta, BMedSc (Hons), Flinders University International Centre for Point-of-Care Testing, Flinders University, Sturt Campus, West Wing, Level 3, Bedford Park, Adelaide, South Australia 5042, Australia. E-mail: Lara.Motta@flinders.edu.au.
The authors received research and equipment support from Siemens Healthcare Diagnostics to establish the Analytical and Clinical Excellence program.
The authors declare no conflict of interest.