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Theme: CLAHRC - Person-Centred Care
Discussions with doctors at diabetes clinic appointments have often been regarded by young people with diabetes (YPD) as lacking in relevance, and therefore providing ineffective support for diabetes self-management. This study will benefit young people with diabetes (YPD) by developing and testing the feasibility and use of Internet or mobile phone-based applications (‘apps’) with which young people will engage with their clinician and focus diabetes clinic appointments on their own agenda. The immediate benefit of this study will be the availability of ‘apps’ developed by YPD and tested by 200 YPD in one consultation. The longer term benefit is in having a defined intervention and evaluation methods for a subsequent study leading to improved attendance at, and satisfaction with, clinic consultations.
Many YPD struggle to maintain good long term blood glucose control leading to irreversible complications. They may be poor at prioritising diabetes-management goals and may not find clinic consultations relevant or helpful. Health care professionals (HCP) may also have limitations in delivering patient-centred consultations. Thus, low self-care motivation and poor clinic attendance amongst YPD are significant challenges. The aim of this project is to develop and test ‘apps’ that engage and empower YPD by setting the agenda for their clinic appointments.
A project team, including e-health researchers from the University of Plymouth, was brought together and as a first stage a successful application to Diabetes UK for a development and pilot study was made. The DUK study is based on a model of co-production with young people with diabetes, supported by the team, being the producers of apps either for mobile devices or the web.
This project was initially inspired by the PenCLAHRC team studying the implementation of a pre-clinic form in adult diabetes clinics
By developing a web-based pre-clinic tool we aimed to:
To achieve our aims, we:
We worked closely with patients throughout our research.
The apps became available in October 2012 and we recruited 200 YPD to test the use of one of these ‘apps’ at their next consultation. We asked YPD if they would re-use the ‘app’ and assessed YPD reported self-efficacy, empowerment, satisfaction with the consultation, likely attendance at future consultations, and perception of concordance with HCP.
We then discussed trial results with health care professionals and other YPD, comparing quantitative measures with qualitative views, to design a subsequent study.
The project therefore aimed to identify and remove barriers to more effective diabetes treatment in young people at high risk from the consequences of non-engagement with medical care.
This Diabetes UK funded project will then allow us to apply for NIHR funding for a cluster RCT.
The final report for the project can be found here: Final Report August 2013
An academic paper from the project was published in November 2014:
Ashurst et al. The Diabetes App Challenge: User-Led Development and Piloting of Internet Applications Enabling Young People With Diabetes to Set the Focus for Their Diabetes Consultations. Medicine 2.0 2014