Posted 15-02-2018.

Spirit Healthcare’s EMPOWER T2n Structured Diabetes Education Programme Recognised for Clinical Outcomes

Spirit Healthcare is proud to announce its success in the recent 2017 LaingBuisson Awards, where its EMPOWER T2n structured diabetes education (SDE) programme for people newly diagnosed with diabetes was recognised as overall winner of the Clinical Services ‘Healthcare Outcomes’ award.

80% of the costs of diabetes are associated with the treatment of the complications of the long-term condition. The Diabetes Control & Complications Trial and the United Kingdom Prospective Diabetes Study (UKPDS) outline the correlation between a lack of treatment of diabetes and other long-term health problems, including heart disease and stroke. In addition, The Diabetes Audit (England 15/16) demonstrated that only 7.6% of those newly diagnosed with diabetes were recorded as accessing SDE in England .

Spirit Healthcare’s QISMET DSME accredited EMPOWER T2n programme is designed to better overcome widely identified patient access barriers to SDE, while its key course elements appear to have translated into patients having learnt appropriate subject matter and set appropriate goals in relation to better health management, leading to corresponding improved levels of glycaemic control.

The EMPOWER T2n programme is delivered as fully managed service by Spirit Healthcare, with a recorded uptake rate in excess of 40% and a Friends and Family Test score of 99%, where 99% of patients were either “extremely likely” or “likely” to recommend the EMPOWER T2n course to friends and family if they needed similar care or treatment.

Evidence from 1,287 participants who gave their permission for their results to be used in research, across NHS East Lancashire CCG, NHS East Leicestershire and Rutland CCG, NHS Leicester City CCG and NHS West Leicestershire CCG, has been analysed to assess the benefits of the EMPOWER T2n SDE programme.

At the end of each programme, participants were asked to record their key learning from the programme and key behavioural changes following attendance, each with space for three goals. Of the 1,287 participants, 2,857 learning responses were detailed. Of these, 65% included words that could be attributed to food or diet and 12% included words that could be attributed to exercise. 2381 behavioural change goals were set. Of these goals, 66% of these responses included words that could be attributed to food or diet and 25% of these responses included words that could be attributed to exercise .

Analysis of participant clinical measures collected, upon referral and then again at six months following completion of the EMPOWER T2n programme, indicates the learning and goal setting from the EMPOWER T2n Programme appears to have resulted in reducing four key clinical indicators directly associated with the long-term adverse outcomes attached to diabetes; HbA1c, cholesterol, blood pressure and smoking, across NHS East Lancashire CCG, NHS East Leicestershire and Rutland CCG, NHS Leicester City CCG and NHS West Leicestershire CCG.

*Figure 1 – EMPOWER T2n Clinical Outputs Aggregated – East Lancashire and Leicestershire

Clinical Measures Baseline Value 6 Month Value Absolute Difference Relative Different Number of Pairs *p Value
HbA1c mmol/mol 60.5 53.2 7.2 12.0% 231 p<0.001
Smoking (number of smokers) 18 11 7 38.9% 73 p=0.019
Blood Pressure Systolic/ Diastolic (mm/Hg) 131.9/77.7 128.7/75.6 3.2/2.1 2.5%/2.7% 214 p=0.001/

p=0.004

Total Cholesterol (mmol/L) 4.2 4.0 0.2 5.6% 157 p=0.007

 

The HbA1c reductions were similar for those whose medicines regime was unchanged versus those whose medicines changed (-7.2% vs. -7.1%; p=0.62). EMPOWER T2n was also associated with participants’ weight being reduced (-1.6Kg, p=0.02).

Gill Peck, EMPOWER Clinical Lead, Spirit Healthcare, comments: “We are delighted that EMPOWER T2n has been recognised in the ‘healthcare outcomes’ category at the LaingBuisson awards. As an organisation, Spirit is committed to helping make the nation happier and healthier by empowering people to better manage their healthcare in line with their chosen lifestyle choices.”

“EMPOWER T2n was developed in 2014 and it has taken 3 years to get us to where we are now. The course has evolved as time has progressed in relation to educator, internal and external reviewer and patient feedback. The project is now being self-sustained, in that commissioners are commissioning it for patients and paying for it. But most significantly, it is helping to achieve our goal of improving care and outcomes of a disease that is growing in incidence and prevalence.”

(* Alpha set to 0.05, two tailed t test with paired data before and after EMPOWER T2n. Not all data was available for 231 individuals analysed with clinical indicators collected at referral and at six months)

i https://en.wikipedia.org/wiki/Diabetes_Control_and_Complications_Trial

ii http://www.content.digital.nhs.uk/catalogue/PUB23241/nati-diab-rep1-audi-2015-16.pdf

iii Data on File. Spirit Healthcare. EMPOWER attendee dataset 4-15 to 10-17. Jan 2018