GP workload driven up by 'over-medicalisation' of patients

Nearly a third of diabetes risk assessments identify that patients are at risk of developing the condition, but GP leaders warn that 'over-medicalising' the population in this way is exacerbating GP workload pressures.

High street advice: GPs concerned at over-medicalisation of patients (Photo: Jim Varney)
High street advice: GPs concerned at over-medicalisation of patients (Photo: Jim Varney)

Research shows that almost 29% of the type 2 diabetes risk assessments carried out in pharmacies reveal a patient is at either moderate or high risk of developing diabetes in the next 10 years. Such patients were then referred to their GP for diagnostic tests.

The researchers, from the University of East Anglia in partnership with Boots UK and Diabetes UK, said the study ‘validated’ early detection, and would allow patients to ‘take steps to prevent or take control of the condition sooner’.

But GPC deputy chairman Dr Richard Vautrey warned this would add to GP workloads and that society needed to confront the ‘big issue’ on the ‘risks and benefits of over-medicalising the population’.

‘The more people who become medicalised, the more people require annual monitoring and advice and support,’ he said.

‘Even if they're not receiving drug treatment, there's still an expectation that you will monitor them in many of the ways you would if they had the full-blown condition, and that takes time which is otherwise fully committed.

‘I think this links into a wider philosophical and ethical debate about over-medicalising the population. When you're setting a particular level of baseline for identifying a group of people, you automatically significantly expand the number of people who would have otherwise considered themselves to be well but all of a sudden find themselves to be the subject of medical scrutiny.’

Encourage lifestyle changes

But Dr Richard Brice, a GPSI in diabetes, said he was ‘all in favour’ of the programme, and earlier detection could help make treatment more effective.

He said: ‘I’m very encouraged that this study shows how easy and accessible a risk assessment tool can be delivered on a population basis.

‘We already know how prevalent type 2 diabetes is, and one of the keys to fighting this epidemic is to identify those at risk of going on to develop the condition and giving them advice, empowering those individuals to reduce their risk through simple lifestyle steps.’

The risk assessment consisted of a short questionnaire to highlight a person’s risk of developing type 2 diabetes. It takes into account a person’s age, gender, waist circumference, BMI, ethnicity, BP and family history. 60% of the risk assessments were carried out on people considered overweight or obese.

The research comes as primary care groups called for greater use of ‘high street’ primary care services, such as pharmacies, to take on more of the GP workload.

It is estimated that 630,000 in the UK have undiagnosed Type 2 diabetes.

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