dr pete davies; p.davies@nhs
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Facilitating diabetes c onsultations through sharing blood test information- “Delivering results to you”. Dr Pete Davies; [email protected]. Facilitating Diabetes Consultations: Share Information. Empower people. Reality Check. The dogma: ‘Good’ diabetes is about ‘good self-care’ - PowerPoint PPT PresentationTRANSCRIPT
Facilitating diabetes consultations through sharing blood test
information- “Delivering results to you”
Dr Pete Davies; [email protected]
Facilitating Diabetes Consultations:
Share Information. Empower people.
Reality Check
The dogma: ‘Good’ diabetes is about ‘good self-care’
The mantra: “Understand diabetes. Take control”
The reality: many barriers inhibit better understanding AND transfer of control/power
How to get Better Outcomes in LTC
Engaged empowered
patient
Organised proactive
system
Partnership
= Better outcomes
All eggs in one basket?
Engaged empowered
patient
Organised proactive
system
Partnership
= Better outcomes
Service redesign; QoF, etc.
e.g. Diabetes education course ever offered:
2006- 11%; 2009- 13%
Lots of focus, attention and investment“Cinderella”
Self-care
The average person with diabetes willspend three hours a year with aprofessional and the remaining 8,757hours caring for themselves.
3
8,760=% 0.03 %
Care Planning
• Usual care– Nurse/doctor led agenda– Telling e.g. results of
tests, examination etc.– Judging– Prescribing– Proscribing
• “thou shalt not”
– Often time-constrained
• Future care planning– Patient/client led agenda– Share results of tests and
examination before the care plan meeting
– Allow time for reflection– Patient is better
prepared to discuss & agree a future treatment plan based on needs and choice
Communicating a measure of glucose control- HbA1c
• A surrogate for glucose control
• Useful clinically• BUT an abstract number, not
easy to explain, or understand• Units of measurement about
to change!
Innovation
• When blood tests processed, send HbA1c result direct to person with diabetes
• Ensure this is received within 5 days and before the care-planning review
• Design the product in a way that – makes the result easy to understand – prompts positive health behaviours– Enhances the care planning process
Health Literacy Dimensions
• Patient group consultation– Convey levels with colour ruler or traffic lights– Good control links to green, healthy plant/tree
Health Literacy Dimensions (2)
• Internet communities: DAFNE-online (UK) & Tu-Diabetes (international)– Feedback on idea & options for graphics and text
(Google Docs) via online survey tool
Professional Help
• One member of patient group was a graphic designer!
• Artwork ideas discussed with 2 independent graphic designers
Descriptor text
• Our aim- reading age as low as possible• Calculated reading age (MS Word)– Flesch reading ease score 62 – Flesch-Kincaid grade level 6.6 ‘easy to read’ for a 13-15 or 11 year old, respectively
• Not bad for an abstract concept
Design Features
Coloured ruler scale
Gives both present and previous results, showing trend
Number and arrow match 3 simple categories
Categories link to NICE targets for diabetes control
Easy to understand descriptors for each category (irrelevant ones faded, to avoid confusion)
Clear advice on what to do next- ‘pause, reflect.. bring to consultation’
Pilot results relevant to design, understanding & empowerment
• Piloted n=1800 Dec 2010-Feb 2011• 8 general practices & my specialist practice
% agreed/strongly agreed
• “Easy to understand” 72% • “Getting it before appointment helped” 73%• “Made it easier to talk to doc/nurse” 76%• “Would like again” 90%Free text: better medication adherence, diet, more
physical activity, more interest in self-care
Summary & Conclusion
• Patient involvement in design enhanced the quality of the product– enabling better understanding
• As an aid to care planning, sharing information in this way– Was acceptable– Led to positive health behaviours, suggesting people
have taken greater control of their diabetes– Enhanced consultations with doctors & nurses
Acknowledgements
