Telephone support for people with IGT in Salford

Download: Success Story Summary, January 2012 (PDF 226.1KB) / Award Entry From (PDF 284.1KB)

The challenge

NHS Salford, working with The Greater Manchester Collaboration for Leadership in Applied Health Research and Care (CLAHRC) wanted to do something to help people diagnosed with impaired glucose tolerance (IGT). There is strong evidence to suggest that without any lifestyle or medical intervention, approximately 50% of people with IGT will develop type 2 diabetes. The team knew that randomised controlled trials have shown that relatively modest lifestyle changes can delay or prevent the onset of type 2 diabetes in people with IGT. They decided to extend a pre-existing telephone support service, called Care Call to patients from Salford diagnosed with IGT.

The aim

The aims of the project were to prevent/delay the onset of type 2 diabetes for people diagnosed with IGT by delivering a telephone-based support service in which 75% of service users achieve and sustain one or more lifestyle goals and that 75% of service users rate as assisting them in achieving one or more lifestyle goals.

What did they do?

Seven GP practices took part in the project. The practices carry out fasting and oral glucose tolerance tests (OGTT), diagnose IGT, undertake an initial Finnish Diabetes Risk Score (FINDRISC) and refer appropriate patients to Care Call. Patients are allocated a named health advisor who makes an initial call to introduce them to the programme and sends out a detailed pack which includes information on ICG, healthy lifestyles and a DVD created for the project about portion size and healthy eating. The individual then receives an action planning call from a health professional which lasts about 40 minutes. The call covers a range of topics including discussing their IGT diagnosis, why it is important to prevent type 2 diabetes and what they can do to reduce their risk. The health professional and patient discuss healthy lifestyles and the individual identifies a lifestyle area they wish to change to help reduce their risk. The person sets an overall six month goal and an initial ‘mini’ goal of how to achieve this. The remainder of the programme is delivered by the named health advisor. Calls lasting about 15 minutes are made at two and four weeks post action planning, and monthly thereafter for a total of six months.

To support the team to monitor the outcomes of patients an anonymous database was set up to record success in achieving goals. On completion of the six month programme, the GP practice performs repeat fasting and OGTT and FINDRISC recalculation and these are also recorded on a database.

What happened?

Interim results have been very positive with significant reductions in fasting and OGTT levels. 50% of people previously diagnosed with IGT now have normal blood glucose levels and 50% have reduced their FINDRISC score.

Service user feedback from focus groups and questionnaires has been overwhelmingly positive, suggesting the service is both informative and valued. All participants report increased understanding of their results and increased confidence in reducing their risk of developing type 2 diabetes. CLAHRC, the Care Call manager and the head of commissioning for long term conditions are considering options for further roll out.

Key outcomes

• 61% of participants have reduced their fasting glucose level, 46% of these are now in the normal range
  
• 73% of participants have reduced their OGTT level, 54% of these are now within normal range
  
• An average of 2.79% weight loss per person has been achieved