How GPs can improve diabetes outcomes and reduce costs

Evidence from a recent survey of people with diabetes, suggests patient outcomes will improve if GPs provide healthcare information in video clips rather than paper pamphlets.

Traditional patient information is failing
"An indication that the current paper and web-based diabetes information is failing to improve patient outcomes is the fact that the incidence rates of diabetes in the UK are escalating. Currently, a plethora of diabetes information is provided either in paper pamphlets or as digitalized text on websites, but patients want healthcare information in video clips, and greater connectivity with their health providers," says Dr Seth Rankin, managing partner, Wandsworth Medical Centre, who conducted the survey.

Despite the NHS spending £10 billion each year on diabetes care, between 2006 and 2011 the number of people diagnosed with diabetes in England increased by 25%: from 1.9 million to 2.5 million. Today, 3.8 million people have diabetes, and this number is expected to increase to 6.2 million by 2035. In 2013 there were 163,000 new diagnoses of diabetes in the UK, the biggest annual increase since 2008, and the five-year recurrence rates of diabetic foot ulcers are as high as 70%. The population increase over the past decade only explains some of these increases.

 

 

Improving outcomes
Organizations treat the distribution of diabetes information as ends in themselves, and report the quantity of information distributed, but not the impact it has on outcomes.
 
By simply asking patients with diabetes how, when and where they would like to receive information to help them manage their condition provides an important missing social link between health professionals and patients, and can help to improve outcomes.
 
Patients' views neither sought nor acted upon
"When we ask patients living with diabetes," says Rankin, "we get a clear picture of what patients want. The fact that patients' opinions are rarely sought, and even more rarely acted upon, might help to explain why the incidence rates of diabetes are escalating. There's no shortage of resources and technical competences in the UK to treat and manage diabetes. However, communications between doctors and their patients living with diabetes throughout their therapeutic journeys are weak. This inhibits patient education, slows self management and quickens the onset of complications," says Rankin. 

Patient survey 
In 2014, 140 people living with diabetes from two London primary care practices participated in a six-week project to improve doctor-patient communications. Patients received regular video clips via email from their health professionals and fellow patients to help them improve the management of their condition. At the end of the project patients' opinions were sought in an email survey, which yielded 51 responses: a response rate of 36%.
 
Findings

• 65% found video information about diabetes helpful
• 72% prefer diabetes information from GPs via email
• 70% want access to healthcare information anytime, anywhere and anyhow 
• 52% prefer healthcare information in video format to paper pamphlets
• 68% want more information about their condition
• 14% visit Diabetes UK's website
• 53% regularly search the Internet for information about diabetes care
• Only 19% can distinguish between good and bogus Internet healthcare information

 
Takeaways
"Providing diabetes information in short video clips featuring local health professionals, which can be easily browsed by patients, creates greater connectivity between doctors and patients.
Unlike health professionals and paper pamphlets, video clips never wear out, and are available 24-7, 365 days a year. Further, any number of people can access them at the same time, from anywhere, on any device.
Our survey suggests that videos clipsare effective in increasing patients' knowledge of diabetes, and propelling them towards self-management. Video clips could be used for all manner of patient information on all manner of conditions," says Rankin.