38 The alphabet strategy for diabetes management; a patient centred, evidence-based checklist approach for reducing complications and healthcare costs

Abstract

Background The International Diabetes Federation estimates 430million cases of diabetes globally. The National Diabetes Audit highlights significant gaps in attainment of national targets, which can result in diabetes-related complications including heart disease, stroke, and retinopathy. The latest report highlighted;

- Type-1 diabetes: only 17.1% achieved good glycaemic control, BP and cholesterol targets

- Type-2 diabetes: only 39.5% achieved these targets

Method The Alphabet Strategy is an evidence-based care plan to manage patients with diabetes. Created at George Eliot Hospital, and included GPs; Nurses, Specialist Doctors and patients. The strategy allows healthcare professionals to provide a personalised care plan to all patients including a specialised plan for patients observing Ramadan.

Results The strategy resulted in significant improvements in glycaemic control, blood-pressure, cholesterol, eye and foot examinations, and guardian drug uptake. Locally, we had the best attainment of targets out of 22 regional Clinical Commissioning Groups. The National Impatient Diabetes Audit highlighted lower admission rates and disease-related complications.

Discussion The Alphabet Strategy philosophy follows our ‘POETIC’ vision;

Patient-Centred, Public-Health driven, Professionally Inspired

Outcome-based,

Evidence-based,

Team-focused,

Integrated across services,

Cost efficient,

Dissemination is ongoing; over 50 teaching workshops and diabetes care events based on The Alphabet Strategy, including the BMJ Masterclass by Professor Patel. The care plan is part of the Sound Doctor diabetes care educational programme, approved by QISMET (Quality Institute for Self-Management, Education and Training).

Conclusion We have learnt that a ‘POETIC’ approach works well. Implementing the strategy can lead to earlier detection of disease-related complications and better patient outcomes.