Evaluating the implementation and structure of the annual diabetes review in Aotearoa New Zealand general practices: a national survey

INTRODUCTION: Annual Diabetes Reviews (ADRs) are a key Ministry of Health initiative designed to ensure comprehensive annual assessment for people with diabetes in Aotearoa New Zealand. Although national guidance outlines core components, the consistency with which ADRs are delivered across primary care remains unclear. AIM: This study aims to assess the structure, components, and delivery of ADRs in general practices, identifying gaps and opportunities for improving diabetes care. METHODS: A National cross-sectional survey was conducted among a 10% random sample (n = 85) of Foundation Standard-certified practices. Practices were invited via email and phone, yielding a 40% response rate (n = 34). Data were collected through an anonymized online or phone survey covering ADR structure, provider roles, and recall systems. RESULTS: Of the 34 participating practices, 32 (94%) conducted ADRs. Nurses were the primary providers (91%), other providers included GPs, healthcare assistants, pharmacists, and Māori health workers. All practices included blood pressure checks, foot examinations, and retinal screening, whereas mental health assessment (56%) and contraception counselling (28%) were less common. Electronic recall systems were used by 94% of practices, though strategies varied. DISCUSSION: Most practices have established processes for delivering ADRs, but implementation of key elements remains inconsistent. The proportion of patients receiving a comprehensive ADR is unclear. Further research involving medical record reviews across sociodemographic groups and qualitative studies of patient and whānau experiences could improve ADR processes.