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Improving the Outcomes of Insulin Pump Therapy Using a Structured Education Programme

Improving the Outcomes of Insulin Pump Therapy Using a Structured Education Programme E Jenkins, J Knott, M Weiss, J Ryder, J Charman, C Shaban, D Cavan, D Kerr Bournemouth Diabetes and Endocrine Centre, Bournemouth BH7 7DW www.b-dec.co.uk melanie.weiss@rbch.nhs.uk. AIMS

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Improving the Outcomes of Insulin Pump Therapy Using a Structured Education Programme

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  1. Improving the Outcomes of Insulin Pump Therapy Using a Structured Education Programme E Jenkins, J Knott, M Weiss, J Ryder, J Charman, C Shaban, D Cavan, D Kerr Bournemouth Diabetes and Endocrine Centre, Bournemouth BH7 7DW www.b-dec.co.ukmelanie.weiss@rbch.nhs.uk AIMS To review how our local clinic has developed since 2008 by introducing structured education in response to a service improvement project. INTRODUCTION Previously, we have shown that the improvement in glycaemic control after initiating insulin pump therapy occurs within the first 6 mths, however a 2008 audit showed consistently average HbA1c levels of 8% (64mmols/mol) >12 months after pump initiation. A Service Improvement Project of 4 focus groups highlighted the need for change. From January 2010 we have added 4 pre-scheduled group review & education sessions during the first year after pump initiation. In the beginning.. Initially 1-6 pts group pump starts Led by DNS Reviewed 1 mth Weekly for first mth (telephone contact) Other follow up according to patient need RESULTS Change in HbA1c after Pump Initiation % Service Improvement Project… Questions Asked P=0.028 Expectations of CSII Have they been met? Advantages Disadvantages If successful , How? P<0.001 HbA1c starting CSII Do they know HbA1c recommendations and why? Barriers in not achieving HbA1c of 7% Change in PAID Scores after Pump Initiation What HbA1c did they want to achieve What would help achieve HbA1c of 7%? Why not successful? P=NS FEATURES OF THE PUMP REVIEW PROGRAMME (DNS and Dietician) Curriculum based Developing independent skills Curriculum based Developing independent skills P=0.028 2 hr review group 1, 3, 6 & 9 mths Data at 3, 6, 9 & 12 months Weight, HbA1c, Hypo awareness ,PAID Data at 3, 6, 9 &12months Weight, HbA1c, Hypo awareness ,PAID CONCLUSION A structured follow-up programme for the first year after initiation of pump therapy leads to additional improvements in glycaemic control and reduced diabetes related distress. 2 groups together Download facilities for pumps, handsets, meters

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