Diabetes Education Study Group

CHAIRMAN'S REPORT
Prof. Aldo Maldonato, September 1999

The Diabetes Education Study Group of the EASD is now 20 years old. First of all I am grateful to Jean Philippe Assal, who founded it in 1979 and initiated many of the activities through which the DESG has significantly improved the care of people with diabetes, in Europe and elsewhere. It is noteworthy that the European Association for the Study of Diabetes has acknowledged this fact by honouring him with the 1999 Claude Bernard Lecture award.

I am also glad to acknowledge the long-lasting partnership with Servier International, a partnership which has existed since the founding of the Diabetes Education Study Group. Thanks to their continuing sponsorship, the DESG can continue to be active and productive. In particular, I wish to thank Dr Didier Halimi, Director, Mr Mike Sumpter and Dr Fréderic Fasano for their personal enthusiastic involvement in the DESG activities.

I wish also to address my thanks to the Executive Committee members: Dr Pesach Segal, the Vice-President; Dr Arun Baksi, the Honorary Treasurer; Ms Birthe Palmvig, the Honorary Secretary; Dr Mikail Antsiferov and Ms Eva Maria Baumer. Dr Stéphane Jacquemet, the Director of Educational Strategies, had to resign in April, 1999 because of his new position at the Geneva University, and I am grateful to him for a short but fruitful collaboration. My warmest thanks also to Ms Margaret Algermissen, in the Rome secretariat.

Since the last General Committee meeting in Barcelona in September 1998, two DESG workshops and one DESG/Servier partnership workshop have been held, new Teaching letters and new Patient Education Basics for type 2 Diabetes have been published and a comprehensive DESG web site has been opened.

CAPRI WORKSHOPS
As anticipated last year, two workshops were held in Capri: one small meeting with the aim of planning a Web site for the DESG, and a larger workshop with the main topic being the implementation of the WHO-Europe Report on Therapeutic Patient Education in the field of diabetes.

Expert Meeting, 11-15 November, 1998
Eleven members from 8 European countries, with experience in therapeutic education and informatics, worked for three days to analyse existing Websites dealing with diabetes, to plan the structure of a comprehensive Website of the DESG which might improve communication between members and make all published material on diabetes education easily available, and to transfer our requests to the webmasters who were in charge of building the site.
The group work on the Internet was made possible by a video projector connected to a computer, and the group’s requests were drafted by means of Metaplan.

Workshop of General Committee Members, 10-16 April, 1999
The workshop was entitled “Therapeutic Patient Education - the Challenge of Diabetes Management” and was attended by 56 members of the General Committee from the following countries: Austria, Bulgaria, Croatia, Czech Republic, Finland, France, Georgia, Germany, Greece, Hungary, Israel, Italy, Lithuania, Malta, the Netherlands, Norway, Portugal, Romania, Russia, Slovakia, Slovenia, Spain, Sweden, Switzerland and the United Kingdom.

The work consisted of short lectures given by invited experts, several activities performed by the participants, and one session of experiential learning based on typical activities of the island. The topics included: “Current ethical issues of chronic medicine: clinical effectiveness, patient’s auto-determination, social appropriateness”, “Good medicine or client’s satisfaction”; “Risks for the asthmatic patient and benefits of therapeutic education”; “Health beliefs and health-related behaviours”, “The consideration of health beliefs in daily routine practice”; “Psychological factors in the motivation to treat oneself and others”, “How to use patients’ motivation in our clinical practice”; “The WHO-Euro Report on Training in Therapeutic Patient Education: how HCPs are trained in TPE in our countries”, “How to implement the WHO-Euro Report in our Countries: the role of the DESG”.

DESG-SERVIER PARTNERSHIP WORKSHOP
For the third consecutive year, a meeting was held under Prof. Assal’s presidency, to illustrate the DESG model to physicians from non-European countries, in order to help improve diabetes care.

A total of 66 participants came to a 5-day workshop held from 10-15 October, 1998 at Villars, Switzerland on the theme: Improvement of Diabetes Care: from learning concepts to implementation of educational programmes. Among the participants were representatives from world-wide Servier subsidiaries, together with members of the healthcare team working closely with them. Participants came from Austria, Belgium, Brazil, Czech Republic, Dominican Republic, France, French Overseas Territories, Guatemala, Hungary, Ireland, Italy, Kazakhstan, Morocco, Poland, Portugal, Russia, Tunisia, Turkey and the United Kingdom.

WHO-EUROPE WORKING GROUP REPORT
After much refining, and thanks mainly to the efforts of the Geneva group, the document was printed in its final version, with the following title: ‘Therapeutic Patient Education. Continuing education programmes for Health Care Providers in the field of prevention of chronic diseases’.

The original English version was printed in Geneva. The DESG has already distributed a copy to the General Committee members who participated in the Capri workshop in April. More copies are available from the DESG, through Servier, and at Prof. Assal’s Unit in Geneva. The French translation is already available and the Italian one will soon be ready.

Hopefully, the entire document will also be made available in the DESG Website.

PUBLICATION AND UPDATE OF TEACHING LETTERS
Four Teaching Letters have been produced this year: No.15 entitled ‘Right from the start... Education at the time of diagnosis’ (new series); No.16 ‘Diabetic retinopathy and therapeutic education’ (new series); No.17 entitled ‘Educational approach to the elderly diabetic patient’ (update); No.18 entitled ‘Group Vs individual therapeutic patient education’ (update).

The other Teaching Letters belonging to the new series, which were drafted during a workshop held in Capri in April 1998, will be published along with the remaining updated Teaching Letters of the first series.

The next to be published are: No.19 entitled ‘Therapeutic diabetes education in (summer) camps’ (new series); No.20 entitled ‘The function of psycho-social support in diabetes education’ (new series); ‘Planning an educational program’ (update); ‘What a diabetes centre should provide’ (update); ‘Diabetes education: tools for evaluation’ (new series).

These Teaching Letters have been or will be produced with the help of the current sponsor, Servier International, and all DESG members will receive copies.

These documents, as well as other DESG productions, are being made available for consultation and free download in the DESG Website.

PATIENT EDUCATION BASICS
We are continuing this new series of documents on different topics involving basic therapeutic education for type 2 diabetic patients, initiated in 1997 as the fruit of a stricter collaboration between DESG and Servier International. Their aim is to provide easy-to-use educational tools for the Health Care Provider wishing to educate the diabetic patient, but unable to find time for a thorough systematic approach. In each of them the most essential messages are summarised and illustrated through drawings.

The Patient Education Basics issues produced this year were the following: No.7 ‘Ageing and diabetes management’; No.8 ‘Improving follow-up in the long term disease’; No.9 ‘Blood glucose monitoring: a must in diabetes management’; No.10 ‘Diabetes treatment and 'the others' (The role of the family and the social environment)’.

During the current year two more Patient Education Basics will be produced: one on ‘Prevention of heart problems’, and the other on ‘Physical exercise: a therapy for diabetes at all ages’.

These documents are also being made available for consultation and free download in the DESG Website.

DESG WEBSITE
As a result of the Capri working group’s suggestions, and after a somewhat longer than expected gestation, the DESG Website was officially opened on September 1st, 1999. Its registered domain name is DESG.ORG (http://www.desg.org).

It is intended for health care professionals involved in therapeutic patient education in the field of diabetes, and the largest part of it is freely accessible. An indication is given for people with diabetes, directing them to a page with many links to several sites with information for patients and sites for patient associations.

For reasons of privacy, both the General Committee members' list and the complete list of members are in a restricted area of the site, accessible to members only. The members' area may also potentially allow for internal communications. Membership gives right to receive the username and password to access the Members' Area. For this reason, from now on, new applicants will have to be endorsed by two established members.

The general philosophy, however, is to leave the site as open as possible, offering as comprehensive as possible a source of information, publications, education tools, various materials, produced either by the DESG or by others, in the field of therapeutic patient education.

A printout of the site map is attached to this report. Some pages are still to be filled with documents, which were not available in electronic format. It has been agreed that future Teaching Letters and Patient Education Basics will be published in the site six months after they are available in print.

Sections to be implemented in the future include: space dedicated to national study groups, the publication of the different translations of DESG documents, and a forum on TPE.
Even if it is not yet fully exploited, I think that one can clearly sense the potential of the Website when exploring it.

UPDATED LIST OF MEMBERS
The updating of the old list of members, which included more than 2200 names, has been completed. The updated list consists of 652 members from 67 countries. It includes all members who filled out and returned to us the Membership Update Form that we sent in May 1998, plus several new entries.

This list is available in the members area of the DESG Website. For reasons of privacy, only the names and contact information of the current executive committee members are in the open part of the Website.

PARTICIPATION IN GRIMENTZ WORKSHOPS
Grimentz Seminars continue to represent a unique model for the interactive learning of educational skills. This year the DESG again provided the funding for some members' participation in two workshops held in Grimentz from 19-24 June and 26 June-1 July, organised by Prof. Jean-Philippe Assal and Dr Alain Golay, respectively.

The first seminar was entitled ‘Traiter et se traiter - mieux prescrire, mieux gérer le suivi du patient - HTA, Diabète, Asthme, Ostéoporose et autres maladies chroniques’. The participants included 70 health care providers. Four participants’ expenses were waived by the DESG.

The second seminar was entitled ‘Stress, émotion et relation thérapeutique. Diabète, obésité à risque, alcoolisme: approches integrées des patients’. The participants included 50 doctors, nurses, psychologists, pedagogues, dieticians, etc. The DESG waived the expenses of two participants.

REPLACEMENT IN THE EXECUTIVE COMMITTEE
In April 1999 Mr Stéphane Jacquemet informed us that his new position in the Education Department of Geneva University prevented him from being able to continue in his position of Director of the Educational Strategies of the DESG, and for that reason he resigned from the DESG Executive Committee.

The Executive Committee has accepted to propose to the General Committee Dr Alain Golay as Director of the Educational Strategies.

SPONSORSHIP OF THE DESG
The generous sponsorship of Les Laboratoires Servier has been confirmed for the next year and continues to be of utmost importance to this Study Group. In addition to the already mentioned Servier team, which is so actively collaborating in the DESG activities, I wish to thank particularly Dr Jean-Philippe Seta, Chief of the Executive Office, and Dr Laurence Alliot, Director of the Medical Affairs Department.

FUTURE ACTIVITIES
One of the main activities in the future will be to improve the DESG Website and to explore its potential as an educational tool for health care providers in the field of patient education.
A new DESG/Servier partnership workshop will be held in order to define a detailed program for training primary care professionals in the education of type 2 diabetic patients.

The continuation of workshops based on the DESG model will be promoted at the national level, with the possible participation of the DESG Executive Committee members.

New Teaching Letters and Patient education basics will be published and distributed.

Prof. Aldo MALDONATO
President, Diabetes Education Study Group
September, 1999