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Clahrc theme - Self management and Education 

 


Theme Lead - Professor Melanie Davies

Theme Manager - Sue Enright

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There are only three studies in this theme all of which are being conducted by the LDC and DESMOND team.



  • A randomised controlled trial of the DESMOND Foundation Programme for people with established Type 2 diabetes in multi-ethnic population in Leicester and South Birmingham. 

 

  • Feasibility trial of the DESMOND Ongoing Model

 

  • Quality Development of Trainers


These are all DESMOND Programme Studies details can be found below.


What is the Theme about?


Most people with long term conditions manage it themselves for the vast majority of the time – 90% in the case of diabetes. A key step in enabling people with long term conditions, such as diabetes, to live full and enjoyable lives is for them to be able to manage their condition as effectively and easily as possible. With an estimated 17 million people in England having one or more long term conditions, ensuring that people receive the appropriate support is vital.

 

The role of the Education and Self-Management Theme is to develop new and extend the range of existing patient education and self-management provision to support and empower people to manage their own conditions. This will make a major contribution to both the health of people and be cost effective for the NHS.
 

In the Self Management and Education Theme we have three main areas of investigation:
 

  • A study to test an integrated approach for promoting effective self-management in people with established Type 2 Diabetes Mellitus - A cluster randomised controlled trial of the Ongoing DESMOND education programme

  • A randomised controlled trial of the DESMOND Foundation Programme for people with established Type 2 Diabetes Mellitus in a multi-ethnic population in Leicester and South Birmingham
  • Work on quality development as part of the structured Self Management and Education Theme

 

 

Study1 - DESMOND Ongoing

To test an integrated approach for promoting effective self-management in people with established type 2 diabetes mellitus (T2DM) – a cluster randomised controlled trial of the DESMOND Ongoing programme

The Study began 01/2011 and is expected to end 06/2013


Principal Investigator: Professor Melanie Davies

Other key staff: Professor Simon Heller, Dr Emer Brady, Professor Alan Brennan, Professor Mike Campbell, Dr Marian Carey, Dr Helen Dallosso, Mrs Heather Daly, Dr Helen Eborall, Dr Clare Gibson, Mr Mike Gillett, Dr Laura Gray, Professor Kamlesh Khunti, Mrs Lorraine Martin Stacey,  Dr Margaret Stone

Partners involved: CLAHRC for South Yorkshire, University Hospitals of Leicester NHS Trust, NHS Leicestershire County and Rutland, NHS Northamptonshire Teaching PCT, NHS Sheffield PCT, NHS Rotherham PCT, University of Leicester, University of Sheffield


Aims


  • To test the effectiveness of an ongoing programme of education and care planning in people with established type 2 diabetes


Summary


The DESMOND Newly Diagnosed programme fulfils national standards for structured education and has been shown to be effective in the newly diagnosed population (Davies et al, 2007). We believe that for the benefits of education to be sustained, continued support for patients is required on top of an initial programme. In addition, patients need to work with health care professionals who are trained to consult in a way which values their contribution and encourages them to participate in every aspect of their care, including decisions about therapy (i.e. the ‘Care Planning’ approach).


The study will evaluate the ongoing effective self-management of people with type 2 diabetes within a primary care setting. The intervention will be delivered over the two years of the study and follow-up will be at 12 and 24 months. We aim to recruit 532 patients from 19 practices (split between the two sites).
 

Study outcomes


  • The primary outcome is change in HbA1c

  • Secondary outcomes include biomedical, lifestyle and psychological variables

 


Further information


If you would like to be involved in this project, or for more information, please contact Dr Helen Dallosso, Research Associate or visit www.desmond-project.org.uk/desmondongoing-300.html

 

Study 2 -DESMOND Foundation Study

A randomised controlled trial of the DESMOND Foundation Programme for people with established type 2 diabetes in a multi-ethnic population in Leicester and South Birmingham

This study is in follow up


Principal Investigator: Professor Melanie Davies

Other key staff: Professor Kamlesh Khunti, Dr Sharad Taheri, Dr Emer Brady, Dr Marian Carey, Dr Helen Dallosso, Mrs Heather Daly, Dr Helen Eborall Dr Laura Gray, Dr Sheila Greenfield Dr Karla Hemming, Mrs Lorraine Martin-Stacey, Dr Parth Narendran, Dr Sabi Redwood, Dr Margaret Stone
 

Aims

 

  • To test the effectiveness of the DESMOND Foundation programme in a multi-ethnic population with established Type 2 diabetes

Summary


Type 2 diabetes is a serious, progressive long-term condition affecting over 2.5 million people in England and when not managed well, can result in blindness, kidney damage, foot ulceration and amputation. Furthermore, it is often associated with complications, which together with chronic high blood glucose levels and additional risk factors increase the risk of stroke, myocardial infarction, peripheral vascular disease and death. The prevalence is greatly increased in certain black and minority ethnic (BME) populations.
 

The DESMOND Newly Diagnosed programme fulfils national standards for structured education and has been shown to be effective in the newly diagnosed population (Davies et al, 2007). DESMOND programmes have now been developed for the South Asian population (DESMOND BME) and for those who have had diabetes for some time (DESMOND Foundation).
 

The present study will test the effectiveness of the DESMOND Foundation programme in a multi-ethnic population with established type 2 diabetes. We aim to recruit 640 patients from 16 practices (320 from eight practices in each site). Participants in the intervention arm will attend a DESMOND Foundation Programme delivered in either English or a South Asian language (Gujarati, Urdu or Punjabi). Follow-up will be at six and 12 months.
 

Study outcomes


  • The primary outcome is change in HbA1c

  •  Secondary outcomes include biomedical, lifestyle and psychological variables

 


Further information


If you would like to be involved in this study, or for more information, please contact Dr Helen Dallosso, Research Associate   
 or visit www.desmond-project.org.uk/foundationstudy-274.html
 

 

Study 3 -  DESMOND Quality Development Study


Principle Investigator: Professor Melanie Davies

Other key staff: Professor Kamlesh Khunti, Sue Cradock, Heather Daly, Bernie Stribling, Lorraine Martin-Stacey, Jacqui Troughton, Marian Carey and Helen Eberol

Partners involved: University Hospitals of Leicester NHS Trust and the University of Leicester


Aims


The QD team as part of CLAHRC sought to answer the following questions

  • Are the current assessment tools reliable in terms of capturing the educator processes?
  • If the tools are used by ‘experts’ to view the same programme, do they get the same results?
  • What are the views of the assessors about the QD process and how would it need to change?
  • What are the challenges in operating such a such a system from the perspective of the educators and coordinators
  • What are the costs associated with the current QD approach?


Summary


The QD process for the current DESMOND ND programme consists of internal and external processes. The internal processes are focused on the educator undertaking personal and peer reflection on their practice following the delivery of a set number of programmes. The external component starts with the initial training support and is followed by the application of external review tools (at predetermined times).
 

The DESMOND observation sheet (DOS) is a paper-based assessment tool designed to assess the extent to which the content and process indicators of observable educator behaviours are being delivered. The DESMOND Observational Tool (DOT) is a quantitative measure of who is talking at 10 second intervals and is designed to assess the interaction of the educator and the participants of the group.
 

A review of the QD processes over the past year has raised concerns about the objectivity of the QD tools, the quality of the feedback from ‘assessors’ and the system’s cost effectiveness.


Further information


If you would like to be involved in this study, or for more information, please contact Bernie Stribling, National Manager for DESMOND  or visit www.desmond-project.org.uk/qualitydevelopmentclarhc-301.html


 

These are all DESMOND Programme Studies for more information visit our DESMOND website www.desmond-project.org.uk