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Articles by D. Hopkins
Total Records ( 2 ) for D. Hopkins
  H. Rogers , E. Turner , G. Thompson , D. Hopkins and S. A. Amiel
  Aims  Structured education programmes for people with Type 1 diabetes can deliver improved diabetes control (including reduced severe hypoglycaemia) and quality of life. They can be cost-effective but are resource intensive. We tested the ability to deliver an evidence-based 5-day programme in diabetes centres too small to deliver the courses.

Methods  Specialist medical and nursing staff from three district general hospital diabetes services (the ‘spokes’) were trained in all aspects of the education programme, except those directly related to course delivery, by a larger centre (the ‘hub’). The hub staff delivered the 5-day patient education courses, but all other patient education and management was managed locally. Diabetes control and quality of life were assessed at 1 year post-course.

Results  In 63 patients with follow-up data, glycated haemoglobin (HbA1c) fell by 0.42 ± 1.0% (P = 0.001), with a greater fall in those with high HbA1c at baseline, and no mean weight gain. Emergency call-out for severe hypoglycaemia fell from 10 episodes in seven patients the year before to one episode in one patient (P = 0.03). Quality-of-life measures improved, with reduced negative impact of diabetes on diabetes-related quality of life (P < 0.00004) and ‘present quality of life’ improving (P < 0.001).

Conclusions  The benefits of a 5-day structured education programme can be provided to patients with Type 1 diabetes attending centres without the resources to provide the teaching course itself, by a ‘hub-and-spoke’ methodology.

  L. Grant , J. Lawton , D. Hopkins , J. Elliott , S. Lucas , M. Clark , I. MacLellan , M. Davies , S. Heller and D. Cooke
 

Aims

Study aims were to (1) describe and compare the way diabetes structured education courses have evolved in the UK, (2) identify and agree components of course curricula perceived as core across courses and (3) identify and classify self-care behaviours in order to develop a questionnaire assessment tool.

Methods

Structured education courses were selected through the Type 1 diabetes education network. Curricula from five courses were examined and nine educators from those courses were interviewed. Transcripts were analysed using framework analysis. Fourteen key stakeholders attended a consensus meeting, to identify and classify Type 1 diabetes self-care behaviours.

Results

Eighty-three courses were identified. Components of course curricula perceived as core by all diabetes educators were: carbohydrate counting and insulin dose adjustment, hypoglycaemia management, group work, goal setting and empowerment, confidence and control. The broad areas of self-management behaviour identified at the consensus meeting were carbohydrate counting and awareness, insulin dose adjustment, self-monitoring of blood glucose, managing hypoglycaemia, managing equipment and injection sites; and accessing health care. Specific self-care behaviours within each area were identified.

Conclusions

Planned future work will develop an updated questionnaire tool to access self-care behaviours. This will enable assessment of the effectiveness of existing structured education programmes at producing desired changes in behaviour. It will also help people with diabetes and their healthcare team identify areas where additional support is needed to initiate or maintain changes in behaviour. Provision of such support may improve glycaemia and reduce diabetes-related complications and severe hypoglycaemia.

 
 
 
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