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Diabetes education – an online future?

Orla O'DonnellToday’s guest post was written by Orla O’Donnell, Project Manager at University College London. With the latest National diabetes Audit Data showing that just 5.3% of people newly diagnosed with diabetes attend structured education, this post explores how technology could help to increase the number of people able to access diabetes self-management courses. 

Britain is currently facing an “epidemic” of Type 2 diabetes, with around 10% of the NHS budget spent on treating diabetes or its complications.  Good self-management is key to improving health outcomes for people with diabetes and can reduce the risk of complications four-fold.  Hence NICE recommends that everyone with Type 2 diabetes should be offered structured education at diagnosis with annual refresher courses.  Unfortunately take-up is very low; according to the National Diabetes Audit 2014/15 only 5.3% of eligible patients attended.  One reason for this may be that all of the current education offered by the NHS is delivered in a face-to-face in a group setting, making it hard for those who work or have caring responsibilities to attend.

One potential way of increasing uptake and therefore contributing to the improvement of outcomes is to offer evidence based self-management education online which complies with current NICE guidance for the associated group.  Potential advantages of internet based sessions include convenience, anonymity, easy updating, and that the resource is always present, whenever the patient needs it.  Offering structured education online allows patients to access information at a time and place convenient to them. They offer increased accessibility for people who work or have caring responsibilities. Online education can also be substantially cheaper than face-to-face education, making it possible to offer people a menu of education services to choose from according to their needs.

With the challenges facing Primary Care and the NHS more generally, including a larger and aging population, budget constraints, and higher expectations of care standards, the use of technology is recognised as a key component in achieving more for less. One example of an evidence based online structured education programme is HeLP-Diabetes – www.help-diabetes.org.uk which was developed with research funding at University College London.

Well developed and trusted online interventions and tools have already started playing an integral role in the modern day NHS and cannot be ignored moving forward.  One of their advantages is cost-effectiveness, with relatively low marginal costs per additional user.  However, this advantage is partly dependent on a high volume of users, as development costs may be significant.  Hence having one central commissioner, commissioning properly evaluated digital interventions for use across the NHS, is likely to be a more efficient model than leaving it up to each individual Clinical Commissioning Group.  Such a model would fit well with the agenda for value-based commissioning and would be one part of the solution to improving uptake of diabetes education for patients, which in turn can lead to improved confidence, ability and motivation to self-manage their own condition.

HelP Online

This article presents independent research commissioned by the National Institute for Health Research (NIHR) under a Programme Grant for Applied Research. The views expressed in this article are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

The views and opinions expressed herein are those of the author and do not necessarily reflect the views of the APPG.

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