16.06.17
How technology can help cut the growing diabetes bill
Source: NHE May/Jun 17
Professor Mike Trenell, chief scientific officer at Changing Health and director of the National Institute for Health Research Innovation Observatory, explains how technology can help cut the growing economic burden that diabetes poses on the health service.
Estimates vary as to its total impact on health budgets, but research from Diabetes UK puts costs close to £24bn. With the number of people living with Type 2 diabetes forecast to grow from four million to five million by 2025, we all know this is a problem that can’t be ignored.
Although the numbers of people with diabetes and the costs of diabetes continue to rise, we are at a tipping point. Science is showing us that diabetes can be prevented, managed or even reversed under the right conditions and support. After years of research by myself, colleagues at Newcastle University and other experts across the diabetes community, we know that helping people to live healthy lives free from expensive complications is achieved by understanding and applying a mix of behaviour change techniques. What we need to do is take behaviour change seriously.
Technology with the human touch
We created the Changing Health digital service after we pinpointed the exact combination of information combined with personalised coaching that was most effective in achieving lasting behaviour change. Why digital? Because we know that printed materials do not translate into behaviour change (a famous study even made them worse!). Furthermore, digital services can be delivered at scale and with a standardised quality of service.
Our approach provides people with Type 2 diabetes full access to the only digital version of the tailored education programme developed by X-PERT Health (via smartphone, tablet or desktop) and a 12-month coaching programme that applies the latest evidence-based behaviour change techniques. This formula of clinically proven education, digital technology and personal human support provides the perfect balance to see a lasting change in patients.
Although this sounds simple, any frontline clinician knows that helping patients to make sustained changes is a huge challenge.
I can’t emphasise enough how important it has been to apply the evidence base while developing Changing Health to ensure success. A recent report warned of a lack of evidence for many of the claims made by so-called fitness apps. In contrast, the Changing Health approach is based on evidence of what works gathered by my team at Newcastle University and Newcastle Upon Tyne NHS FT, after they identified the optimum combination of digital information and coaching back-up needed to get patients to improve their health (don’t worry, we’re not trying to replace people just yet, coaches play a vital role!).
Our research demonstrated that those who become more physically active and lose weight will not only reduce the impact of Type 2 diabetes, but potentially reverse the disease altogether.
The impact on health organisations could also be significant. People with Type 2 diabetes who move more and manage their weight go to the doctor less and require less drugs.
By helping to reduce obesity and increase physical activity, fewer patients will go on to suffer heart- and limb-related problems too. There are real and tangible benefits to both the NHS and patients. The question is no longer whether we should support behaviour change, the question is how do we deliver it effectively and at scale.
It’s impossible to overstate the challenge Type 2 diabetes poses to the NHS. Estimates vary as to its total impact on health budgets, but it is between £11.6bn and £14bn every year.About 80% of this is spent on the treatment of conditions which arise as the disease worsens, such as amputations and heart disease.
We strongly believe, based on clinical evidence, that if patients are offered accessible, easy-to-understand help and ongoing support to reach goals, we will start to see an easing of this huge and unnecessary burden on NHS resources.
That’s why I’m so excited to see Changing Health already being referred to thousands of patients in London, Manchester and Birmingham, with other cities getting ready to launch later in the year.
There is a pressing need to help people change their behaviour and live longer, healthier lives. Digital technology allows us to connect and educate one another in a way we could only have dreamed of a generation ago. But we need technologies that bring these insights together for the good of patients. It’s cost-effective, easy to deliver and, when backed by genuine expertise and research, it works.
Tell us what you think – have your say below or email [email protected]