ABSTRACT
Aims: A proof-of- concept pilot investigating the profile of person who engaged with remote testing for their annual diabetes review, and service user (SU) and primary care practice acceptability for completing annual diabetes review tests remotely (blood pressure, finger-stick blood test and urine test). Method(s): A mixed methods evaluation based on SU surveys sent to all 144 pilot participants, semi-structured SU and staff interviews, and demographic and clinical data extraction from primary care electronic patient record system. Result(s): Profile: The pathway was considered suitable for people who were working, digitally capable, younger, had household support to complete the tests, had non-complex diabetes, or a combination of these attributes. It was deemed less suitable for the very elderly, the less digitally capable, those with complex health needs or socially isolated. SU Acceptability: Interviewees and survey respondents overall deemed the remote tests acceptable for use. Convenience and reduced exposure to Covid-19 were motivating factors for participation. Preference for face-to- face care or concerns around using digital technologies were key reasons for decline. Staff Acceptability: The pathway was deemed acceptable and was successfully implemented at both practices. Support from a designated pathway co-ordinator and project manager were key factors linked to acceptability and success. The remote pathway was seen as an opportunity to reduce primary care pressures on in-person care. Conclusion(s): It is possible to successfully conduct annual diabetes reviews remotely. Although not appropriate nor desirable to everyone, remote testing provides a viable alternative to in-person testing for certain individuals.
ABSTRACT
Aims: Historically the National Diabetes Prevention Programme (NDPP) has low retention rates which are accentuated in the BAME population. We aimed to design and deliver a fun, alternative type 2 diabetes prevention programme that would have an increased retention rate and increase participant's physical activity levels. The Diabetes Prevention Decathlon (DPD) structured education programme featured;weekly health and well-being workshops and physical activity sessions, gamification and the use of a mobile phone application that incentivised continued physical activity between sessions. Method: An innovation grant awarded the opportunity for collaboration between multiple partners within the NHS, public health, community charities, patient groups, and a digital enterprise. This resulted in the creation of the DPD which was piloted in a deprived South West London borough. The inclusion criteria for participants included a HbA1c between 42 and 47 mmol/mol (6.0-6.4%), indicative for non-diabetic hypoglycaemia. Referrals, retention rates, weight loss and physical activity data were recorded over the ten-week programme alongside key demographic markers. Results: With an 87% completion rate (n31), 39 kg group weight loss and 40% increase in activity levels, the programme yielded excellent results compared to the NDPP. Semi-structured interviews highlighted the importance of group interactions and regular opportunities to be physically active. Positive but unplanned outcomes were the high BAME uptake of 77% and subsequent retention 67%, and covid driven agile conversion to virtual delivery. Conclusions: The DPD successfully piloted a new and fun approach to diabetes prevention with further intentions to work with local communities to increase and improve BAME resources.