Diabetes in Scotland 2004
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A recent meeting heard that patients should be empowered
to make informed decisions that are clinically effective. Steven
Kayne reports
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The “Diabetes in Scotland 2004” conference was jointly organised by Diabetes UK and the Scottish
Executive (Government)and took place in Glasgow on 12 November
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Diabetes links
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Patient empowerment — is it a new
approach or just this year’s buzzword?
Robert Anderson: show you care about patients first and their diabetes
second |
Most health care delivery systems are poorly configured to treat chronic
diseases such as diabetes effectively, according to Robert Anderson of
the Department of Medical Education, University of Michigan, in Ann Arbor.
Health professionals are well trained to deliver episodic symptom-driven
care but often struggle with the treatment of chronic disease for which
they have little direct control once the consultation has ended. In these
cases daily care is largely in the hands of the patient.
Professor Anderson was delivering the newly instigated J. J. R. MacLeod
Lecture at the conference. He said that pharmacists were often frustrated
and discouraged when patients did not follow their advice. In spite of
the great advances that have been made in the treatment of diabetes in
recent years, many patients still experienced devastating complications
that cause a decrease in the length and quality of life and cost the
health system money.
This can happen when the self-management plan has been designed to fit
the requirements of a patient’s disease but without considering
his or her culture, lifestyle, personal goals, priorities and resources.
To manage diabetes successfully, patients must be empowered to set goals
and make informed decisions that are clinically effective and satisfy
complex personal psychosocial needs. It is necessary to establish a partnership
with patients and their families to develop a collaborative approach.
Professor Anderson said that we should show that we care about our patients
as individuals first and about their diabetes second. Intervention strategies
should encourage patients to assume day-to-day responsibility for their
diabetes care. Professor Anderson outlined a five-step process similar
to continuing professional development, involving the provision of information
and guidance through a reflective process designed to facilitate the
development of both diabetes- and lifestyle-related goals. Patients are
then invited to adopt an appropriate behavioural change consistent with
the achievement of their chosen long-term goals and to evaluate their
efforts after an agreed period. Important OTC advice role
In a workshop that highlighted the potential problems associated with
over-the-counter medicines, Margaret Ryan, head of prescribing management,
NHS Argyll and Clyde, described community pharmacists’ important
role in identifying potential interactions and inappropriate self-treatment.
A number of common OTC products can interfere with blood glucose control,
she said. Many diabetic patients are taking drugs for other related conditions
and need guidance. The availability of so many variants with similar
brand names causes confusion for many patients, who should be encouraged
to read the label carefully. |
The
Pharmaceutical Journal