Healthy.io’s ACR ‘Adherence as a Service’ enables people to test their urine at home using a test kit and accompanying app. The service improved adherence to ACR testing from 0% to 79% in patients with type 1 diabetes who had been offered the traditional model of care multiple times but did not attend, and consented to participate. This helped identify abnormal ACR in 17% of the patients that tested, that might not otherwise have been identified.
of those tested had an abnormal or high abnormal result, indicating previously unknown albuminuria
of patients contacted agreed to receive a test, out of which 79% completed an ACR test at home
of patients agreed the service was easy to use
preferred home testing to attending the clinic
An abnormal ACR test is an independent risk factor for both cardiovascular and chronic kidney disease (CKD). ACR testing is one of the worst performing of NICE recommended diabetes care processes, and is more frequently missed in people with type 1 diabetes than people with type 2.
The project was offered in collaboration with Diabetes Care for You, a service at Sussex Community NHS Trust, for patients living with type 1 diabetes across the Brighton and Hove and High Weald Lewes and Havens CCG areas.
Patients were contacted by Healthy.io’s patient onboarding team, who provided information about the service, the importance of annual ACR testing, and supported patients to download the app.
Patients who consented to take part were sent a kit at home and a link to download an app that talks them through the process of home testing.
After completing the test, the results were available in SystmOne, the local electronic patient record system, for clinician review. Patient followup was initiated based on the ACR results.
94% of patients contacted agreed to receive a test, out of which 79% completed one at home
97% agreed the service was easy to use. 89% preferred home testing to attending the clinic
£533,572 in year 5 (£18,995 in year 1) Projected savings for Brighton and Hove and High Weald Lewes and Havens CCGs
£51,504,556 in year 5 (£1,833,571 in year 1) Projected savings for NHS England
David Lipscomb
Diabetes Clinical Lead
Sussex and East Surrey Health & Care Partnership