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Publications policy and guidance
Management of medicines - a resource to support implementation of the wider aspects of medicines management for the National Service Frameworks for Diabetes Renal Services and Long-Term Conditions
- 8. References
- 9. Acknowledgements
- To order a copy
- 1. Introduction
- 2. Improving the effectiveness of medicines
- 3. Safety
- 4. Joined-up care
- 5. Dispensing medicines
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6. Tools
- Introduction
- Assisted administration - medicines support and monitored dosage systems
- Audit tools
- Clinical guidelines technology appraisals and systematic reviews
- Discharge medicines
- Education and training for patients
- Education and training for carers
- Education and training for clinicians
- Information for patients and carers - Internet
- Local Pharmaceutical Services
- Medication error reporting and analysis
- Medication review
- Medicines management collaborative
- Monitoring of medicines of 'high risk'
- Non-pharmacological approaches
- Out-of-hours services
- Patient and user organisations
- Patient Group Directions
- Patient involvement
- Patients' Own Drugs in hospitals
- Pharmaceutical industry resources
- Practice guidance and resources
- Prompts and reminders
- Repeat prescribing system review
- Self-administration of medicines in hospital
- Service development
- Shared care guidelines
- Supplementary prescribing
- Waste reduction strategies
- 7. Next steps: A framework for action
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Education and training for patients
Education for patients can be provided in groups or on a one-to-one basis and can be led by professional or lay educators.
Lay-led self-management training programmes are complementary to, and not an alternative to, education about specific conditions and their management, whether layor professional-led.
NICE guidance on the use of patient-education models for diabetes 2003
The guidance recommends that structured education be offered to all people with diabetes at the time of diagnosis and then, as required, based on a formal, regular assessment of need. Principles of good practice are set out. Education in groups is recommended unless group work is considered unsuitable for an individual. It is also recommended that the education is provided by multi-disciplinary teams in a variety of formats.
Source: NICE Technology Appraisal no. 60. Guidance on the use of patient-education models for diabetes.
Group education in primary care for people with diabetes
A diabetes nurse educator works across Castle Point and Rochford PCT, helping practice nurses develop skills in diabetes management. Patients can be referred by any healthcare professional in primary or secondary care and they have the option of a one-to-one or group session. At group patient education sessions, patients fill out a pro forma identifying all their medicines and what they want to get from the session. Individual needs may relate to any aspect of diabetes care, including medicines. The needs identified are then used to produce individual management plans. Common medicinesrelated questions raised by patients in group sessions include who patients can ask for advice on dose alteration, who can help them understand whether their medicine is working for them, what the side-effects are, how long the medicine will need to be taken for, and what to do if a dose is missed.
Contact: Alexis Hodgkins, Diabetes Specialist Nurse, Castle Point & Rochford PCT, Essex.
Dosage adjustment for normal eating (DAFNE) in diabetes
DAFNE courses teach people with Type 1 diabetes how to adjust their insulin to suit their lifestyle. The programme enables them to eat what they want when they want. Research evidence shows that people can improve their glucose control without having severe hypoglycaemic episodes.
Contact: Gillian.Thompson@northumbria-healthcare.nhs.uk
Medicines and the Expert Patient Programme
One of the sessions in the generic lay-led self-management courses in the Expert Patient Programme discusses the use of medicines in chronic conditions. Patients 'freethink' the methods they use to help them to take their medicines. As 'homework', they compile a list of all their medicines (prescribed and over-the-counter), doses and what each medicine is for. The intention is that patients can keep their working list, update it when needed and take it with them for their contacts with health professionals. This ensures that the health professional has a full picture of all the medicines the patient is taking. Feedback from patients about the session has been positive.
Contact: Brenda Spettigue
Peer support in diabetes
The Isle of Wight has a scheme where 24 people with diabetes have completed intensive training to act as peer support counsellors on all aspects of diabetes. Volunteers were invited to participate through local advertisements and during outpatient consultations. Training sessions were held weekly for 17 weeks. In addition to providing support to people with diabetes and their carers, the peer support counsellors have played a more active role with local patient associations and have attended open meetings of the Primary Care Trust to help develop local plans. Twelve have volunteered to lecture at the next training programme.
Contact: Dr Arun Baksi
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