Servier Grant Reports
The following grants were successful under the Servier ADS Grant Scheme in 2009 for projects commencing in 2010.
John Furler - Stepping Up Insulin Initiation in GP study
Most patients with T2D will require insulin yet this is often delayed in general practice. This project aims to pilot and evaluate the implementation of the “Stepping Up” program in general practice (see below) to help patients with poorly controlled type 2 diabetes (T2D) for whom insulin is indicated move onto insulin in a timely, evidence-based manner. The “Stepping Up” program involves supportive education for GP and practice nurse and a reorientation of the way GP and PN work together in working with patients towards starting insulin. This model of care is sustainable and potentially has wide application for improving patient diabetes outcomes in General Practice.
GPs and Practice Nurses from three participating General Practices will attend a 2 hour evening training session about initiating insulin, identify 2-3 patients who are eligible to start insulin in their practice and develop their own “in-practice” system for linking those patients with the practice nurse to discuss intensifying their diabetes treatment. GP and PN will attend a final two hour evening session two months later to discuss their experience of the project and patients will attend a focus group.
Jeff Flack - Dietetic Intervention to Minimize Excessive Weight Gain in Early Pregnancy
A/Professor Jeff Flack, Ms Robyn Barnes, Ms Jane Hardman.
Diabetes Centre, Bankstown-Lidcombe Hospital Eldridge Road BANKSTOWN, NSW 2200
Gestational Diabetes Mellitus identifies an at-risk pregnancy, as well as an increased long-term risk of Type 2 diabetes in the mother. Excessive weight gain in pregnancy is a known independent predictor of fetal macrosomia and contributes to maternal obesity. Aim: To establish an early intervention to achieve optimal weight gain in pregnancy in all women presenting to the antenatal clinic [ANC]. Methods: Introduce and evaluate a dietetic service involving the following components: development of a written resource for all women booked into the antenatal clinic [translated and printed in 3 languages]; distribution of this resource at the first ANC appointment; and provision of group dietetic education. This service will be trialed for a 6 months period, with all women receiving the intervention being followed up until delivery. Evaluation will involve assessing the following: attendance at group education sessions; pre and post knowledge; weight gain in pregnancy; number who develop GDM; delivery method; infant birth weight.
Melanie Burkhardt - Behavioural Management of Type 1 Diabetes in Young Adults: An investigation of adherence to medical and lifestyle regimens, metabolic control and psychological wellbeing
Standard care for young adults with Type 1 diabetes typically involves regular appointments with the doctor, diabetes educator and dietician. However, better health outcomes also depend on the consistency with which patients manage everyday personal behaviours contributing to better metabolic control. For well over 50% of people with chronic health problems, long-term adherence to medical treatment and lifestyle regimens is poor. The central aim of this research project is to establish higher levels of adherence to conventional medical and lifestyle diabetes care regimens via an innovative functional behaviour analytic approach. The approach is packaged as our Back for Action Program (BAP) which has already proven successful in changing patterns of everyday behaviours and routines of older people. By improving adherence levels we aim to improve glycaemic control and thus reduce the risk of acute and chronic diabetes-related health complications in this population. This study will experimentally evaluate the BAP as applied to young adults with Type 1 diabetes who are already receiving conventional multidisciplinary care. If successful, the package will provide a foundation for future research by extending the behaviour analytic approach to optimize diabetes care for a wider population of adults with Type 1 and Type 2 diabetes.
