CLAHRC South London's diabetes theme aims to improve health outcomes for people with diabetes mellitus, in which optimal outcomes in diabetes depend on active self-management. Research shows that people with diabetes benefit from ‘participating in structured learning around how best to manage their diabetes, but a study ‘Barriers to Uptake of Diabetes Education’ (BUDiE) led by Dr Sophie Harris, deputy clinical director for diabetes at the Health Innovation Network (HIN) and a diabetes doctor at King’s College Hospital found that less than one third access group education around self-management of their insulin therapy.
The BUDiE Study involved asking adults who have type 1 diabetes living in Lambeth and Southwark (an estimated 1,600 people) about how they think healthcare professionals can help them to better manage their condition, and what would make a self-management course more appealing. It also involved interviews and focus groups with health care professionals. One outcome was a desire for opportunities for modular and self-directed learning. So researchers co-created a diabetes website (www.T1resources.co.uk) with patients and clinicians, which contains mixed-media reliable information for self-management of diabetes, such as video clips of DAFNE courses and tips about travel with type 1 diabetes. Users can register to comment on resources or give a rating. An editorial group of professionals and users vet resources to be included. The website was launched in September 2016 and has around 1,000 visitors per month. The findings have influenced the successful bid for NHS England transformation funding to improve uptake to diabetes education courses locally. Results of the study also informed the redesign of the structured education programme, DAFNE.
The study findings have informed the development of a new education hub run by our AHSN partner the Health Innovation Network (HIN), with new referral pathways and there will be opportunity for people to attend a course that suits them independent of who their usual care provider is.
Contribution of CLAHRC South London
The CLAHRC South London, funded running costs and consumables of the BUDIE study and facilitated engagement, enabling researchers to recruit 496 patients and 56 healthcare professionals.
It helped to fund the website design and promote the launch of www.T1resources.co.uk The work was profiled at the CLAHRC’s annual PPI event in March 2017, where Dr Sophie Harris and patient Sarah Gatward presented to over 100 patients, researchers and service users. The CLAHRC PPI theme enabled Dr Harris to host a thank you event for participants in the research attended by 35 people to discuss key results of BUDiE.
What happened next?
Data from the BUDiE study is feeding into an NIHR programme to improve the outcomes of DAFNE - DAFNEplus. Researchers have also collaborated with Bournemouth Diabetes and Endocrine Clinic to update and extend access to an online education module on carbohydrate counting www.bertieonline.org.uk. In addition, DAFNE (Dose Adjustment For Normal Eating) patient champions were set up to talk to peers about their experiences of the course and allay any fears.
To address the lack of understanding of DAFNE by healthcare professionals, training in DAFNE is now being integrated into specialist registrar doctors’ training in south London. 35 doctors training in diabetes and endocrinology will be trained by 2020, with a rolling programme to provide training for a further 12 doctors per year. Future plans include work on the barrier posed by poor numeracy and health literacy skills.
The study findings have informed the development of a new education hub run by our AHSN partner the Health Innovation Network (HIN), with new referral pathways and there will be opportunity for people to attend a course that suits them independent of who their usual care provider is. There will also be an option to self-refer and education resources for healthcare professionals. The hub will go live in November 2018.