Information prescriptions for patients with diabetes
While primary care professionals bear the brunt of most diabetes treatment, current clinical interventions are not adequately supporting self-care. Amy Rylance, head of healthcare professional engagement at Diabetes UK, takes us through their new tool to better monitor patients’ health.
Diabetes is the health problem of our time: 3.8 million people have diabetes in the UK, and a further 11.5 million people are at high risk of developing Type 2 diabetes. The vast majority of those treating the disease are primary care professionals, who report their frustration that time pressure along with the number of tests they have to carry out mean that the opportunity to explore what matters to the patient, or to change behaviour and therefore the clinical outcomes, can be lost.
Data shows that current clinical interventions aren’t supporting self-care effectively: the latest National Diabetes Audit (2012-13) showed that only 36% of people with diabetes achieve the NICE targets for blood pressure, cholesterol and HbA1c (long-term blood glucose).
This is despite the fact that these factors place people at risk of devastating complications, such as blindness, kidney failure, heart attack, stroke, or amputation. They’re also treatable with routine drugs such as statins, and lifestyle interventions. If you’re not yet convinced that this matters, consider this: the NHS spends £8bn a year treating diabetes complications that could be prevented if the above targets were achieved.
Primary care needs support; not more tasks to add to the tick list, but tools that make it easier to deliver quality care. To provide this Diabetes UK has worked with the primary care IT suppliers to develop ‘information prescriptions’, a new tool that enables effective interventions in a matter of minutes. They work as follows:
- Target those at highest risk: We’ve used the NICE guidelines to create prompts within primary care IT systems. If a patient has diabetes and falls outside the NICE recommended targets for blood pressure, cholesterol, or HbA1c, the clinician receives a pop-up alert upon opening the patient’s medical record.
- Swift interventions: There is no searching for documents or transcribing of patient information. The pop-up links to the appropriate information prescription with the patient’s information auto-completed.
- Supports care planning: Simple check boxes on the information prescriptions allow generic advice to be individualised whilst the ‘action plan’ box draws on the best evidence around effective behaviour change.
- Enables continuity of care: A copy of the completed information prescription is saved in the patient’s notes so that past goals can be recalled quickly in future appointments.
- Signpost back to Diabetes UK for further support: A URL on the information prescription directs patients to key topics to enable self-care, such as information about diet, medication and education.
I will leave the final words to Dr Stephen Lawrence, diabetes lead for the RCGP and primary care medical advisor for Diabetes UK, who said: “Information prescriptions put patients in the driving seat, and that’s the key to driving successful behaviour change. It’s an invaluable tool that GPs and healthcare teams can easily incorporate during routine care."
“Having piloted it I know that it works, and the feedback I’ve had from patients is that they feel more in control and like having clear goals set out to help them improve their health. This is a revolutionary step in diabetes care.”
To find out how to activate information prescriptions at your practice visit: http://www.diabetes.org.uk/Professionals/Resources/Information-Prescriptions-QA/