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Blog: Personal findings on diabetes information prescriptions

Last summer I was asked by Diabetes UK to join a pilot for simple one-page plans individually tailored for people with diabetes whose condition is not fully controlled.These 'information prescriptions' pop up on a health professional's screen if a patient with diabetes hasn't hit their target for HbA1c, blood pressure or cholesterol.  The information prescriptions also contain the crucial information people need on how to better manage their diabetes as well as the pre-agreed personalised action plan..

Now information prescriptions are launching nationwide on EMIS Web, with other software providers to follow, and I would urge practice nurses and others in primary care to adopt them as soon as possible and make them an integral part of your diabetes toolkit.

Certainly since I started using them,  there has been a noticeable increase in the amount of information patients have retained and their awareness of their diabetes. I'm sure this is because information prescriptions provide the chance to prioritise the patient's specific problems and challenges. It gives patients the framework to understand that their lifestyle and behaviour affects their HbA1c, their blood pressure and their cholesterol.

One of my diabetes patients has bulimia. Working with the information prescription, we set a couple of goals - one of which was to stop smoking and the other was to stop comfort eating. She has successfully managed to quit smoking but is still comfort eating. However, I do feel that this is a big step; she is now far more engaged in her care.

I'm also finding that the information prescriptions format is really opening my eyes about my patients' knowledge about their diabetes, or rather the lack of it. One of my patients was drinking a large sweet shake every day and proudly told me he had made the 'healthy' switch to a couple of digestive biscuits. Obviously there is still work to do, but at least I feel I am having conversations with people which shines a light on their problems.

Of course the personalisation of the information prescriptions is what makes them so effective and, especially with people from different ethnic groups, I tend to personalise them even more by talking about portion control and changing the balance of the amount of carbohydrates - which often make up a very large part of African and South Asian diets. It can be really hard to change behaviour when it is so culturally rooted, but information prescriptions are all about the person with diabetes making changes to their behaviour that they can stick to in the long term. The idea is that if the patient is able to get their condition under control, they will in turn reduce their risk of diabetes complications such as amputation, blindness and kidney failure.

The fact that this is a 'prescription' of advice and information really seems to resonate with patients. They understand it's not just a magic wand, but that they also have a part to play. It is still too early to tell whether we will see a significant improvement in numbers of patients hitting their targets, but I feel confident that in the long-term information prescriptions will make a difference.

For more information about information prescriptions visit Diabetes UK 

Sandi Kendall, 53, is a practice nurse at Colliers Wood surgery and Lavender Fields in South London and piloted diabetes information prescriptions.