Improving the management of diabetes

 
Keen to discover the effectiveness of short healthcare videos as a communication tool for patients, Dr. Seth Rankin, the managing partner of Wandsworth Medical Centre, London, emailed his patients living with diabetes short videos about their condition, and surveyed their opinions afterwards, which we report.
 
The clinicians
"Healthcare information in video format distributed directly to patients' mobiles is a more effective way to educate people living with diabetes, and propel them towards self management with an eye to slowing the onset of complications," says Rankin.    

According to Dr. Sufyan Hussain,an endocrinologist and lecturer from Imperial College, London, Clinical Lead on the Wandsworth project,  "Despite accounting for 10% of the NHS budget and 8% of UK's population diabetes healthcare systems still need considerable improvement, particularly in management, strategy and infrastructure. Communicating important health information via video, can help significantly to improve the quality of care and efficiency in an over burdened healthcare system."
 
Patient survey
 
During the six- week project, over 50% of diabetes patients opened the emails sent, and watched the information videos about their condition.
  • 75% of respondents say that they would like to have more reliable information to help them to manage their diabetes
  • 44% regularly search the Internet for healthcare information about diabetes, and 20% are undecided
  • Only 9% say that they can differentiate between good and bogus online healthcare information about diabetes
  • 68% found the video information they received by email helpful
  • 21% regularly visit Diabetes UK website
  • 71% want GPs to provide more healthcare information via email
  • 50% prefer to receive healthcare information about diabetes in video format, and 23% are undecided
  • 71% believe it's important to access healthcare information about diabetes at anytime, from anywhere and on any device.
It's important for me to quickly access premium and reliable healthcare information about my condition at anytime, from anywhere and on any device
NICE relaxing guidelines
These findings, if indicative of patient views, are significant. Recently, the National Institute of Health and Care Excellence (NICE) issued new draft guidelines to make more people eligible for weight-reduction surgery. According to NICE, such surgery would reduce the debilitating complications associated with type 2 diabetes.

Until now, people with type 2 diabetes only could be considered for weight loss surgery at a BMI of 35. The new guidance could mean that more than 850,000 people could be eligible for a stomach-reduction surgery if their doctors think they are suitable.

A costly therapy
Over the past five years, there has been a significant increase in the number of people receiving weight loss surgery. According to the UK's Health and Social Care Information Centre's latest report: in 2012-13, about 8,000 people received stomach-reduction surgery for potentially life threatening obesity when other treatments failed.

A mounting body of evidence suggests such surgery improves symptoms in around 60% of patients, which in turn, may result in a reduction in people taking their type 2 diabetes medications, and even in some cases needing no medication at all.

Stomach-reduction surgery, which costs between £3,000 and £15,000, does not mean that type 2 diabetes has been cured, and there are raised concerns that the NHS will not be able to afford the treatment, even if there are savings in the longer term. Furthermore, an irreversible procedure that does have surgical risks attached to it does not make it an attractive option for everyone. 
 
Takeaways
"We know about the escalation of the diabetes burden. We know that established therapies, diets and lifestyles could effectively reduce the burden of diabetes. And yet the burden shows no signs of slowing. IF patient data from the Wandsworth Medical Centre are indicative of the situation more generally, we should seriously consider the way doctors communicate with patients. Doing 'more of the same' is not the answer. We need to find new innovative solutions to engage, interact and motivate as many people as possible," says Dr. Hussain.

 

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