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  • Keynotes Diabetes UK March 2007 4* Newsletter of the DESMOND Collaborative & Network T his year, 2007, is special to all who have been involvedbeginnings. stages of the DESMOND Programme since its earliest in the various At this year’s Diabetes UK Annual Professional Confer- ence, the study investigators, on behalf of the DESMOND Collaborative, will present the final results from the DESMOND randomised controlled trial. Aside from its positive outcomes, the study is a great example of part- nership and teamwork: between primary care, re- searchers, practice staff and patient participants. DESMOND owes a debt of thanks to many people and or- ganisations. We hope the results justify the hard work and dedication of our partners. Meanwhile, it’s good to remember that the DESMOND is nothing less than a radical new vision of intergrated care for people with Type 2 diabetes, deliv- erable in the community. This means that while the RCT may have drawn to a close, 2007 also marks a year of beginnings! We would like to encourage health care professionals in primary care to think about participating in one of the new research projects underway this year. For anyone currently providing the Newly Diagnosed module, we have news on the Foundation programme for people with established diabetes, and an update on the imminent BME (Black and Minority Ethnic) module. And as it is only possible to give a taster of what is happening in the world of DESMOND in these pages, please do feel free to contact the Central Office team for further information. Dr Sue Roberts National Clinical Director for Diabetes
  • D ESMONDreview into structured education in diabetes, which of the NICE originated in 2003 as a direct result of the findings at that time found a lack of Type 2 diabetes education in England ful- filling the criteria for quality, evidence-based programmes. In response, a collaborative group from the UK pooled their expertise and experience to envision a new way of delivering diabetes care in line with the National Service Framework for Diabetes and NICE rec- ommendations. The work of the DESMOND Collaborative as it be- came, is directed by a Steering Group of 45+ individuals representing 13+ diabetes services, drawn from the spectrum of professions with an interest in the condition, and includes people with diabetes and representatives from Diabetes UK. Structured education is central to this vision, not simply because it is identified in all recent policy documents as an essential component of modern diabetes care, but because it is widely recognised in chronic disease programmes worldwide as critical to engaging individuals in the self-management of their condition. Without education there can be no long-term reduction in the complications of diabetes and the consequent costs in human, clinical, societal and economic terms. The DESMOND Randomised Controlled Trial (RCT) T he DESMONDarandomisedgroup education programmetrialpa- ing globally of structured controlled trial is the largest in ongo- tients newly diagnosed with Type 2 diabetes. After three years of hard work and commitment by all concerned, the study completed data collection in January 2007. The trial itself took place in 13 sites in England and Scotland, with a Backgroun total of 17 Primary Care Trusts (PCT) and 207 practices participating. Of the1109 patients referred, 824 consented to take part. The level of return of follow up data was extremely good, with over 90% of patients providing data at 12 months follow-up. We are also fortunate that Dia- betes UK has funded further follow-up of the participants to be con- ducted at 3 years. Following the presentation of the study results at this year’s DUK con- ference, we will be looking forward to seeing the first papers of the study appearing in the scientific press. Meanwhile, a selection of cur- rent and recent references from the DESMOND project can be found on the following page.
  • references T he followingstudy and the Newly Diagnosed structured education DESMOND references are a guide to further information about the module. For the full current bibliography, contact Claire Sutcliffe ( Conference abstracts DALLOSSO HM, CAREY ME, DAVIES MJ, HELLER S, KHUNTI K, SKINNER TC (2006). Evaluating complex interventions in primary care: a progress re- port on the DESMOND trial. Diabetic Medicine, 23(Suppl. 2):121. DAVIES MJ, CAREY ME, DALLOSSO HM, HELLER S, KHUNTI K, SKINNER TC (2006). Biomedical results at baseline and 12-month follow up from the DESMOND (Diabetes Education and Self Management for Ongoing and Newly Diagnosed) pilot study: P356. Diabetic Medicine. 23(Suppl. 2):119. DAVIES MJ, CAREY ME, DALLOSSO HM, HELLER S, KHUNTI K, SKINNER, TC on behalf of the DESMOND Collaborative (2006). ‘Effects of a structured education programme on illness beliefs, QoL and physical activity in individ- uals newly diagnosed with Type 2 diabetes: the DESMOND pilot study’, poster presented at the 42nd Annual Meeting of the European Association for the Study of Diabetes; 14-17 September 2006; Copenhagen. SKINNER TC, DAVIES MJ, CAREY ME, DALLOSSO HM, HELLER S, KHUNTI K (2006). DESMOND pilot study (Diabetes Education and Self Management for Ongoing and Newly Diagnosed): belief and behaviour changes main- tained through 12-months follow-up: P359. Diabetic Medicine, 23(Suppl. 2):119-120. Peer reviewed and professional journals CAREY M and DALY H, 2004. Developing and piloting a structured, stepped approach to patient education. Professional Nurse, 20:37-9. SKINNER TC, CAREY ME, CRADOCK S, DALY H, DAVIES MJ, DOHERTY Y, HELLER S, KHUNTI K, OLIVER L (2006). Diabetes education and self-man- agement for ongoing and newly diagnosed (DESMOND): process modelling of pilot study. Patient Education and Counselling, 64; 369-377 STONE, MA, PATEL N, DRAKE L, GAYLE C, 2006. Making education in dia- betes culturally appropriate for patients. Practice Nursing,17(12);621-625.
  • 2 006 has been a growth year for the DESMOND Newly Diagnosed Programme. At present, over 60 of the newly configured Primary Care Trusts have be- tween them over 325 Educators offering DESMOND as their local pro- gramme for people newly diagnosed with Type 2 diabetes. This makes DESMOND accessible to over one third of the UK population. Our 3 regional teams have been travelling the length and breadth of the country training new Educators. To date they have delivered 25 Train the Ed- ucator courses. With an ever-growing ‘waiting list’ to take up the Newly Diag- nosed module, the pending release of both the Foundation DESMOND and DESMOND Black and minority ethnic (BME) modules, the future for DESMOND looks extremely bright. We owe a debt of gratitude to members of our regional training teams and their organisations for this success. In addition to maintaining the high standard of our training, this year has seen the introduction of the quality development (QD) framework. Through this we provide ongoing mentoring and assessment for Educators, leading to accreditation within the DESMOND Programme. Educators are men- tored through the process by one of our trained QD Assessors. The QD process has been developed to ensure the consistency of content and delivery within the DESMOND philosophy, wherever and by whom DESMOND courses PCT for patients are delivered. If you are a Trust representative, a health care professional interested in DESMOND, or sim- ply want more information about the DESMOND programme, please do not hesitate to contact any of the Central Office Team who will be happy to answer your questions. Michael Bonar & Alison Harding look after the operational/logistical side of the Programme, with Michael, as Programme Manager, dealing with finance and design, and Alison, as Oper- ations Coordinator, being responsible for training and quality development. 18 Programme
  • Be a pioneer in primary care! Y ou may have can still the opportunity to participate in the DESMOND RCT, but you missed take up the challenge to be a pioneer by taking part in one of the two studies below. If your organisation is delivering the DESMOND Newly Diagnosed programme as part of routine care, there is still time to register interest and apply for further information. SMBG Blood glucose monitoring study T he DESMOND Collaborative has received three year funding from Dia- betes UK to run the Self Monitoring of Blood Glucose Trial. The study will investigate whether self-monitoring of blood glucose as opposed to uri- nalysis provides additional benefit to newly diagnosed patients with Type 2 diabetes receiving structured group education. Like the DESMOND randomised controlled trial, this study will take place in primary care. Practices will be randomised to refer patients to a DESMOND course that covers either blood glucose monitoring or urinalysis. Recruit- ment of PCTs has already begun, but it is not too late to take part. For further information without obligation contact Helen Dallosso (helen.dallosso@uhl- Lay Educators Lay Patient Educator Study C delivereducators working in partnership with health care professionals an lay the DESMOND Newly Diagnosed Module with the same integrity and to the same standard as a health care professional team? That’s the question to be answered by this study funded by Diabetes UK, and taking place in primary care. If the answer is positive, and if the economic implica- tions are favourable, then this study has the potential to signpost a cost ef- fective way for primary care organisations to increase their capacity to deliver structured education. We are looking for 6 PCTs to participate. Recruitment and training of lay ed- ucators would be organised by the study research team. Monies are avail- able for items such as training, course resources and payments to HCP and lay educators for their time. For further information and to register interest without obligation, contact Panna Mandalia (
  • BME D ESMOND for the South Asian Community The long wait is almost over! In Au- tumn 2007 training for Interpreters and Educators to deliver the DESMOND module for the South Asian community will at last be avail- able. This will be supported by cultur- ally appropriate resource packs and patient materials developed by health care professionals in conjunction with patients and their communities. Building on the work of our Diabetes UK-funded action research project, work has been continuing over the last 6 months to shape up existing materials, create exciting new re- sources, and develop a one-day train- ing programme for Interpreters and the Educators working with them to deliver this breakthrough DESMOND programme. Further information and costs will be available from June 2007. But to reg- ister interest without obligation, con- tact Alison Harding (
  • Other Projects Research in development T for DESMOND Foundation Module, an initialmirrors the Newly Di- he people with established diabetes which 6 hours of education foundation agnosed Module, will shortly be available in the form of a conversion pack to accompany the current manual issued at Educator training. It will be provided free of charge to all existing Educators actively deliv- ering DESMOND in PCTs with a current subscription to the pro- gramme. Subsequently, it will be provided as an integral part of the Educator Manual to new trainees. T the Foundation Module DESMOND integrated pathway. Model, his main section of the will pave the way for the Ongoing ongoing At the present time, funding is being sought to support piloting of the training, patient education and clinical management sections of the model as developed by the task groups of the DESMOND Collaborative. M eanwhile, we are pleased tomodule hasthat a DESMOND pre-dia- betes prevention education announce recently received funding as part of a larger Diabetes Prevention Programme grant. pre-diabetes This education module will target those at risk of developing diabetes and focus on diet and lifestyle issues, in particular on increasing levels of physical activity. The five year research study will be steered by an international group of investigators.
  • contact us Do you have a question about DESMOND? Interested in taking on the programme? Want to know more about taking part in research? Whatever your information need, there is someone in our team who can provide answers. DESMOND Project Team Dr Marian Carey DESMOND Central Office National Director Ward 38, Level 6, Windsor Building, t: 0116 258 7757 Leicester Royal Infirmary, e: Infirmary Square, Leicester, LE1 5WW Claire Sutcliffe PA to National Director t: 0116 258 7757 t: 0116 258 7757 f: 0116 258 6165 e: w: Research Dr Helen Dallosso Senior Research Associate t: 0116 258 5881 e: Panna Mandalia Research Associate t: 0116 258 5881 e: Programme Michael Bonar Programme Manager t: 0116 258 5881 e: Alison Harding Operations Co-ordinator t: 0116 258 5881 e: