Slide no 1 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 12 Congreso Latino Americano de...

Slide no 1 • Soren E. Skovlund DAWN Programme Novo Nordisk • August 2004

12 Congreso Latino Americano de Diabetes 28 September 2004


DAWN Symposium Programme ALAD 2004

• The DAWN Programme in the ALAD perspective Antonio Chacra

• The DAWN Programme in the SACA perspective Susana Campanella

• The DAWN Worldwide Call to Action Soren E. Skovlund

• Assessment of psychological well-being – taking DAWN into action Frank Snoek

• Preliminary results of the DAWN questionnaire in Argentina Juan José Gagliardino

• Discussion and conclusions for Latin-AmericaPanel


The DAWN world-wide call to action

for better diabetes care

Soren E. Skovlund, Msc,Dgr.

Senior Adviser, head

Global DAWN Programme

Novo Nordisk

Denmark


Overview

•The global DAWN (Diabetes Attitudes Wishes and Needs) Study

•The DAWN Call to Action

•Regional and national implementation of DAWN


The DAWN Programme

•A Novo Nordisk initiative in collaboration with the International Diabetes Federation and an International Expert Advisory Board

•Began in 2001 with the DAWN (Diabetes Attitudes Wishes and Needs) study

•A long-term commitment to improve the health and quality of life for people with diabetes by focusing on the person


The aim of the DAWN programme

•To overcome the psychosocial barriers to health and quality of life through facilitation of concrete initiatives and best practice sharing worldwide


DAWN is an expression of the Novo Nordisk vision

•To defeat diabetes by finding better methods of diabetes prevention, detection and treatment

•To work actively to promote collaboration between all parties in the health care system in order to achieve our common goals


Why the DAWN study?

•Number of people with diabetes will double in the next 25 years to over 300 million worldwide

•Today less than 50% of people with diabetes achieve satisfactory control of their blood sugar, despite the availability of effective therapies


Objectives of the global DAWN study

•To understand attitudes wishes and needs of people with diabetes and identify the psychosocial barriers to good treatment outcomes for people with diabetes

and

•provide a framework for concerted action and dialogue between all parties in the healthcare system world-wide


Study methodology

•Structured interviews of:

• 5.400 adults with diabetes

• 3.850 healthcare providers• 2.200 physicians

• 550 specialist physicians

• 500 nurses

• 600 specialist nurses

•Australia•France•Germany•India•Japan•Netherlands•Poland•Scandinavia•Spain•UK•USA


The DAWN study questionnaire

Health careprovision

PersonalityDiabetes

knowledge/beliefs

Socioculturalenvironment

Everyday lifepatterns

Psychologicalhealth

Physical health

Diabeteshistory

Effective self-management


The DAWN study revealed critical gaps in diabetes care

•Psychosocial problems and poor diabetes self-management is a worldwide issue

•Healthcare professionals are not able to offer the needed psychosocial support for people with diabetes


Psychological well-being ofpeople in the DAWN study

Less than half of the healthcare professionals said they were able to provide adequate psychosocial support

58%

42% Good well-being

Poor well-being


Irrational beliefs delay use of effective diabetes therapy

More than half are worried about starting on insulin

Half believe that starting on insulin would meanthey had failed to manage their disease

Only one fifth believe insulin would help themmanage their diabetes better

More than one third of physicians postpone insulinuntil “absolutely essential!”

Two-thirds use insulin as a threat with their patients


The DAWN study suggests a new approach to diabetes

Well-being/social support

Effective self-management

Optimal glycaemic controland quality of life


How to translate the DAWN study into

ACTION?


Translating DAWN into Practice- The 2nd Intl DAWN summit

London, November 2003

• 150 delegates, 31 countries • People with diabetes, NGOshealthcare professionals, media and politicians


The DAWN world-wide call to action

To improve outcomes in diabetes, we must address the people

behind the disease


Five goals were confirmed for concerted advocacy and action:

1. Enhance communication between people with diabetes and healthcare providers

2. Promote communication and coordination between healthcare providers

3. Promote active self-management

4. Overcome emotional barriers to effective therapy

5. Enable better psychological care for people with diabetes


Novo Nordisk can facilitate regional action with DAWN:

•Best practice sharing world-wide

•Facilitate broader use of existing tools

•Workshops, tools, strategies for clinicians

•Applied research and concrete guidelines

•Platform for cross-disciplinary dialogue

• Intl. ambassadorship for policy change


• Raise awareness and advocacy

• Mobilise people with diabetes

• Train healthcare providers

• Provide practical tools and systems

• Drive policy and health-care systems change

• Develop psychosocial researchin diabetes

The DAWN framework for regional implementation









COPIES AVAILABLEAFTER THIS SYMPOSIUM









LAY PRESSMEDIA

EMPOWERINGPEOPLE

e.g. United States

GermanyAustralia

DIABETES PASSPORTS







• Develop psychosocial research in diabetes

NationwideTRAIN-THE-TRAINER workshops adapted

for local needs

DAWN into existingtraining materials

CD-ROM s and Web



Best Practice of training: Poland

•3-year nationwide training program

•STEP 1: Specialists trained to train GPs

•STEP 2: 7.000 GPs and 2000 nurses were trained by specialists in integrated medical-psychological approach

•Regional conferences with speakers from the DAWN International Advisory Board








NationwideTRAIN-THE-TRAINER workshops adapted

for local needs

DAWN into existingtraining materials

CD-ROM s and Web











DAWN PATIENTQUESTIONNAIRES

database

Primary careCenters

WHO-5 WB Index in good spir.. active and.. calm and rel..



The DAWNEXPERIMENT:

- ASK- LISTEN 5 MIN - RESPOND- ENCOURAGE















IDF-DAWNGLOBAL PSYCHOSOCIAL

DIABETES GUIDELINEPROGRAMME









Clinical and socioeconomicresearch toevaluate thebenefit of the psychologicalfocus


How to take action in Latin-America

• Use DAWN study findings to start dialogue between all local stakeholders in diabetes about how to place the person with diabetes in focus

• Identify key stakeholders to drive action and local the agreed priority areas for DAWN action

• Utilise DAWN programme materials, clinical tools, networks and concepts to start initiatives that will benefit large group of people with diabetes

• Learn from more than 20 other countries who are implementing the DAWN study!


What are the priorities for action in Latin-America?

1. Enhance communication between people with diabetes and healthcare providers

2. Promote communication and coordination between healthcare providers

3. Promote active self-management

4. Overcome emotional barriers to effective therapy

5. Enable better psychological care for people with diabetes


Thank you

•Please pick up the Diabetes Voice Special Issue after the symposium

•For more information:Contact Novo Nordisk ([email protected])

•DAWN website:www.dawnstudy.com

http://www.dawnstudy.com/



• Dr. David Matthews (UK) Oxford Centre for Diabetes, Endocr. & Metabolism

• Dr. Frank Snoek (NL) Vrije Universiteit, Dept. of Medical Psychology Chairman, PSAD study group, EASD

• Ruth Colagiuri (Aus) VP, Australian Diabetes Educators Association

Director, Australian Centre for Diabetes Strategies

• Dr. Line Kleinebreil (F) DiabCare France, Hôpital Jean Verdier

• Rüdiger Landgraf MD (G) Medizinische Klinik, Universität München

• Dr. Hitoshi Ishii (J) Tenri Yorozu Soudanjyo Hospital,

• Dr. P.H.L.M. Geelhoed (NL) Duijvestijn Haaglandlanden Hospital

• Richard Rubin (USA) Johns Hopkins University School of Medicine

• Ib Brorly (DK) Person with type 2 diabetes

• Dr. Torsten Lauritzen (DK) Aarhus University

The DAWN International Expert Advisory Board 2004

DAWN Programme – Reference Slide Kit – © Novo Nordisk


DAWN References

• Practical Diabetes International, Vol. 19 (1), pp. 22-24a, 2002 . The DAWN (Diabetes Attitudes, Wishes and Needs) Study

• Practical Diabetes International, Vol. 19 (6), pp. 187-192, 2002 The Oxford International Diabetes Summit: Implications of the DAWN study: 7-8 April 2002, Oxford, UK

• Practical Diabetes International, July 26th Issue, 2004 The 2nd DAWN International Summit: A worldwide call to action: London, UK

• Diabetic Medicine, Psychosocial Problems and Barriers to Improved Diabetes Management: Results of the Cross-national Diabetes Attitudes, Wishes and Needs (DAWN) Study, International DAWN Advisory Panel, prov. accepted, Diabetic Medicine, 2004.

• Geelhoed-Duijvestijn, P., Peyrot, M., Skovlund, S., Rubin, R., Matthews, D., Kleinebreil, L., Lauritzen, T., Colagiuri, R., and Snoek, F. "Physician Resistance to Prescribing Insulin: An International Study." Diabetologia, 2003.

• Peyrot, M.,, Matthews, D., Snoek, F., Colagiuri, R., Kleinebreil, L., Rubin, R., Ishi, H., Lauritzen, T., Geelhoed-Duijvestijn, P., and Skovlund, S. "An International Study of Psychological Resistance to Insulin Use among Persons with Diabetes." Diabetologia, 2003.

• Peyrot, M., Rubin, R., and Siminerio, L. "Physician and Nurse Use of Psychosocial Strategies and Referrals in Diabetes." Diabetes, 51 (Sup. 2): A446, 2002

• Rubin, R., Peyrot, M., and Siminerio, L. "Predictors of Diabetes Self-management and Control." Diabetes, 51 (Sup. 1): A437, 2002

• Peyrot, M., Rubin, R., and Siminerio, L. "Physician, Nurse and Patient Perceptions of Diabetes Care." AADE 29th Annual Meeting Program Book, 28: 255, 2002

• Peyrot, M., Rubin, R., and Siminerio, L. "The Effect of Initial Response to Diagnosis of Diabetes on Later Adjustment." AADE 29th Annual Meeting Program Book, 28: 256, 2002

http://home.novo.dk/webhotel/hcb/dawn/links_and_resources/docs/Physician%20and%20Nurse%20-%206-10%20JL%202.pdf

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