Improving our health by translating research evidence into local NHS practice
theme 8
Implementation of effective community care for diabetes
Theme Lead
Dr Shahrad Taheri, Consultant Physician at Heart of England NHS
Foundation Trust and Senior Lecturer in Medicine at University of
Birmingham.
On
the whole, the aim of this implementation theme is to enhance the
overall management and care of patients with diabetes in the community.
This includes developments ranging from patient identification,
education and treatment .The objective is to ensure that evidence-based
tenets of diabetes care are implemented in a cost-effective manner.
Different aspects of the Theme are:
1) A
randomised controlled trial of the DESMOND (Diabetes
Education and Self Management for Ongoing
and Newly Diagnosed) Foundation Programme for people with
established Type 2 diabetes in a multiethnic population in Leicester and
South Birmingham.
Type 2 Diabetes currently affects 2.3 million people in
England and Wales. The impact of the recently announced government plans
for a national screening programme for diabetes will result in the
identification of even more patients. South Birmingham PCT will put in
place a comprehensive package of care that includes structured education
(DESMOND) and psychological support to promote uptake of preventative
services and to promote behavioural change across the economically and
ethnically diverse local population.
We will evaluate the DESMOND programme and measure uptake
of services (such as screening for retinopathy and consultation with a
nutritionalist), effects on diet and exercise, attendance for necessary
check ups and glucose control achieved. We will also measure quality of
life over time and conduct qualitative research to identify barriers to
care and glean a deep understanding of what the disease and its
treatment mean to different groups of people. The results of the
research will be used to adapt the care package in ways that are
sensitive to different sectors of the local population.
A
Sub-study will aim to collect qualitative data through interviews in a
subset of participants, in order to assist with interpretation of
quantitative results, particularly in respect of the reasons underlying
positive and negative findings.
2)
Using a collaborative arts-based activity to elicit South Asian women’s
views and beliefs about Type 2 Diabetes. This is being led by Dr. Sabi
Redwood, a medical sociologist. This is an arts-based approach
permitting more natural talk, the kind through which lay knowledge is
constructed and communicated. The data elicitation technique used avoids
‘question-answer’ style interviews which may be culturally
inappropriate. This is a collaborative activity which mirrors food
preparation and cooking, with the aim of creating a more appropriate
space to talk about food and health. The activity is facilitated through
personal contact with community groups and led by a local artist,
Caroline Jariwala.
We also have 4 PhD
students on the Theme who are working on the following:
-
Rolling analysis of diabetes care- Correlation Data on Epidemiology of Diabetes And Related conditions (CEDAR).
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Cultural and social factors which influence Indian Punjabi men’s health beliefs and how they shape perceptions of risk related to type 2 diabetes.
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Primary care Research Into Diabetes Evolution (PRIDE).
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Developing a self-management intervention for type 2 diabetes patients. More
