1. SUPPORTING PRIMARY CARE TO ACHIEVE TARGETS

2. What targets? 1.9 care processes 2.3 health targets (HbA1c, blood pressure, cholesterol) AND IMPORTANTLY Quality care from a patient and professional perspective

3. WHY SHOULD HEALTHCARE PROFESSIONALS WORK WITH US?

4. INFORMATION PRESCRIPTIONS

5. Why do we need information prescriptions? It is estimated that around 95% of diabetes care is self management 1 A study from 2002 showed of 4000 patients prescribed metformin only 65% were taking the medication as prescribed 1 year later 2 For patients prescribed more than one drug (metformin and Sulphonylurea) that falls to 44% 2 Non-adherence in chronic diseases averages 50% by 1 year 3 1.Wagner, EH Groves, T. (2002) Care for chronic diseases. BMJ 325: 913 - 4 2. 2. US population 2002. J Int Med Res. 2002;30:71 3.3. WHO.Adherence to longterm therapies:Evidence for action.Switzerland,2003

6. INFORMATION PRESCRIPTIONS Given by clinician to patient Personalised Specific Clinically accurate Easy to read Supports care planning & behaviour change Part of clinical systems Intervention to address 3 big targets: Blood pressure, Cholesterol and HbA1c What is an information prescription?

7. Why b lood pressure, cholesterol and HbA1c ? 1.People are not controlling these factors – Type 1 diabetes only 16% met all three targets 4 – Type 2 diabetes only 37% meet all three targets 4 2. Poor control has devastating consequences – “heart failure emerges as both the most common and the most deadly cardiovascular complication of diabetes... High blood pressure is an important risk factor for heart failure” 5 3. We can do something about them – Lifestyle changes and routine drugs e.g. statins 4. State of the Nation 2015 5. National Diabetes Audit 2011–2012, Report 2: Complications and Mortality

8. Clear, clinically accurate, information Actions to reduce risk Signpost for support and information Personal Personal care planning

9. Analysis of seventeen randomized controlled trials showed … the setting and reviewing of behavioural goals and providing information about when, where and how to be physically active (action planning) were related to clinically significant improvements in HbA1c. 7 Participants who set themselves goals (e.g. eat a low-fat diet, increase physical activity) and who made an action plan lost significantly more weight than those who did not. 6 Supports care planning & behaviour change 6. Hankonen, N., Sutton, S., Prevost, A. T., Simmons, R. K., Griffin, S. J., Kinmonth, A. L., & Hardeman, W. (2014). Which Behavior Change Techniques are Associated with Changes in Physical Activity, Diet and Body Mass Index in People with Recently Diagnosed Diabetes? Ann Behav Med. doi: 10.1007/s12160-014-9624-9 7. Avery, L., Flynn, D., Van Wersch, A., Sniehotta, F. F., & Trenell, M. I. (2012). Changing physical activity behavior in type 2 diabetes. Diabetes Care, 35, 2681-2689.

10. Data in Data out 1.Targeted 2.Specific 3.Personal 4.Quick 1.Medical record 2.KPIs 3.Stats on use

11. SUPPORTING SELF-MANAGEMENT