HeLP-Diabetes

Type 2 diabetes is one of the most prevalent long term conditions, with an estimated prevalence of 4 – 6%. Nationally it accounts for about 10% of the total NHS budget. Good self-management is key to achieving good health outcomes in diabetes and preventing complications, and structured education, leading to improved self-management skills has been shown to reduce the risk of complications four-fold but it can be difficult to engage patients in structured education.

Most current structured education (e.g. DESMOND, X-PERT, Co-Creating Health) is offered as group sessions and take-up is sub-optimal.  National Audit Office data suggest that nationally, fewer than 10% of newly diagnosed patients attend structured education.  HeLP-Diabetes is a sophisticated web-based self-management programme for people with type 2 diabetes. The programme takes a holistic view of self-management and addresses a wide range of patient needs including medical management, emotional management, and role management.

HeLP-Diabetes has been developed by a team of academics, NHS clinicians and patients.  The NHS clinicians include GPs, consultant diabetologists and dieticians. The academics are based at UCL and other leading UK universities and include health psychologists, clinical psychologists, sociologists and clinical academics.  The content of the programme has been informed by initial qualitative work with patients and health professionals involved in caring for people with diabetes, and patients and health professionals have been involved throughout the development process through a participatory design process.  We employed a software company and a web designer to ensure a professional and easy to use finished product.  Funding was provided by the National Institute of Health Research.

In addition to the online programme which can be used by patients at any point in their illness journey, according to their evolving needs, we have developed an online structured education package with individual email support from two experienced Specialist Diabetes Nurse Educators.  This package consists of 8 modules, delivered fortnightly, or as preferred by the patient.  The curriculum covers all aspects of diabetes self-management, including information, emotional support and behaviour change support.

Data from a small pilot study in 3 practices in North London showed that patients (n = 18) who used HeLP-Diabetes over 6 weeks showed significant improvement (reduction) in their level of diabetes-related distress, as measured by the Problem Areas in Diabetes (PAID) scale. HeLP is currently being used in a randomised controlled trial in 22 GP practices across England.  HeLP-Diabetes is the first programme of its kind in the UK and has the potential to save the NHS thousands of pounds as online interventions are considerably cheaper to run than face-to-face sessions.