Diabetes Education Study Group

CHAIRMAN'S REPORT
Prof. Jean-Philippe Assal - September 1996

I wish to thank Servier International for their continuing support of our Study Group and with whom we have a very fruitful relationship. I should also like to address my thanks to the following Executive Committee members: Mrs. Lisbeth Vang our Honorary Secretary who now comes to the end of her mandates after nine years of outstanding help and enthusiasm for our Group; Dr. Daniel Figuerola the Vice-President; Dr. Ivana Piva, our Honorary Treasurer; Prof. Urban Rosenqvist as Director of Educational Strategies; finally Mrs. Melodie Käser who runs the Geneva secretariat.

Since our annual meeting in Stockholm in 1996, new publications have been made, an expert workshop has been held and the organization of the DESG Symposium set up. These items are expanded upon below:

1996 DESG EXPERT WORKSHOP, GOZO, MALTA
A three-day workshop was held from 1-17 March on the island of Gozo (Malta) on the subject of 'Improving long-term follow-up of people with chronic diseases'. The themes covered were 'What comprises long-term follow-up?', 'Defining new skills for long-term follow-up', and 'Building a medical curriculum for long-term follow-up'.

A total of 28 experts, covering the professions of physician (in hospital and general practice setting), nurse, specialist in education, psychologist and anthropologist, corning from eleven different European countries. They met in order to draw up a new concept of a 'survival kit' but this time purely for doctors in the way of guidelines for their daily practice. This document is intended to be practicable for General Practitioners in order to help them in the integrated follow-up of patients having long-standing chronic diseases.

Discussions were held and the following topics debated:
1) Long-term patient / HCP Compliance
2) Patient versus Health Care Provider Perspective
3) Professionals: The Need for Support
4) Identity of the Health Care Providers
5) Process of Helping
6) Methods for Developing Constructive Approach
7) Strategies of Follow-Up

Discussions also covered such subjects as the real meaning of long-term follow-up and avoiding 'burn-out', patients' health beliefs about the disease and its treatment, the different aspects of health care delivery which urgently need improvement, the various skills which are missing and possible avenues for doctors' curriculum which could feasibly be put into practice. The participants then formed seven working groups to produce precise and concise suggestions for the final guidelines on each subject. These documents were then critically read and discussed by all participants. Each group selected a member to be responsible for their final document. All documents are now with the main DESG secretariat. A final editing will shortly be made in order to have continuity between those documents and the official version of this 'Kit' will be available in the not too distant future.

THE DESG 5-MINUTE 'SURVIVAL KIT' FOR HCP AND PATIENTS
As mentioned in the previous Chairman's Report, this 'Kit' has since been published as a working party report in Diabetic Medicine, Vol. 12, 1995, pp 1022-1043. It has also been published in as an article in other languages, for example in the Sloval medical journal 'Solvensky Lekar' of June 1996.

It has now been translated into twenty two different European languages (Albanian, Arabic, Armenian, Bulgarian, Estonian, French, German, Georgian, Greek, Hungarian, Italian, Latvian, Lithuanian, Norwegian, Polish, Portuguese, Romanian, Russian, Slovakian, Spanish, Swedish, Turkish). The previous sponsor of the DESG, Novo Nordisk A/S has published, or is in the process of publishing, through its affiliates, approximately twelve of these translations at this present time.

PUBLICATION OF NEW TEACHING LETTERS INCLUDING EDUCATIONAL POSTERS
Following the distribution last year of the educational poster entitled 'Therapeutics and Education', a Teaching Letter has now been produced and is available from the DESG Secretariat. A second Teaching Letter has now been produced, together with its educational poster and this is entitled 'Help your patients to improve self-management'. All members of the DESG will receive a copy of these Teaching Letters, including small posters. Large posters are available from the DESG Secretariat. All members of the General committee will receive both these documents, together with the large poster of the second Teaching Letter. As mentioned in last year's Chairman's Report, further topics will be covered, e.g. 'Attitudes which imprison doctors and patients', 'Following a patient on a long-term basis implies...', 'Following a treatment for many years implies...', and 'Relapse prevention'. We reiterate that the aim of these posters is to summarize, through image, main concepts in therapy of chronic diseases, which are very often difficult to describe in writing.

UPDATE OF PREVIOUS TEACHING LETTERS
The original Teaching Letters, which were produced in 1988, are, as you know, currently being updated. Three of those Letters were already available in Stockholm, on the topics of 'Oral agents', 'Hypoglycemia', and 'Self-monitoring'. Three more letters are now available and will be distributed to all members of the General Committee. They cover the topics: 'Putting a patient on a diet', 'Counselling on late complications' and 'Foot care'. Updating of the remaining letters is still continuing. These will also be sent to all DESG members.

The updating of these Letters is being done with the help of the current sponsors, Servier International.

DESG HALF-DAY SYMPOSIUM: SUNDAY, 1 SEPTEMBER, 1996
The DESG has been appointed by the EASD, together with the Pregnancy and Islet Study Groups, to hold a half-day Symposium at the beginning of the annual EASD meeting in Vienna, Austria. This Symposium is entitled 'Patient Education Revisited: from learning techniques to long-term follow-up'. A participation of 4-600 participants is envisaged.

After an introduction by the President based on the seventeen years activity of the DESG within the EASD, a critical analysis of the major activities is to be presented, followed by a presentation from the Director of Educational strategies on the various uses of patient education. A conference on whether the application of the St. Vincent Declaration has improved patient education and care is to be given by the Chief of Quality of Care & Technologies from the WHO Regional Office for Europe. Two round tables will be held, with discussion time, the first on 'Difficulties encountered in developing an education programme' and the second entitled 'Towards an Official Curriculum for Patient Education'. Panel members have been chosen from different European Countries. The Vice President will be discussing experiences with patients' health beliefs including a video presentation. A summary of the meeting will be held on the topic 'Long-Term Follow-Up: A new concept as old as medicine. What are our needs?'

OTHER BUSINESS
During the annual General Committee meeting held last year in Stockholm, there was discussion about approaching the EASD to provide lower fees for student membership, thereby allowing them to take advantage of the lower rate for registration for the EASD annual meetings. The point of view was generally held that access to the important meetings is very difficult for certain members of the health care team and a special price would perhaps enable them to partake more readily. It should be noted that the EASD now has a special Student Membership Registration Fee, without 'Diabetologia' in the sum of DM70 (£30), which is approximately half that of a yearly, under 35 years, membership. This is aimed at undergraduate students or postgraduate science students. The DESG feels that such a registration fee should also be open to nurses and other health care providers and steps are currently being taken to elucidate this matter.

FUTURE ACTIVITIES
Two, one-week workshops will be held from 5-10 and 12-17 October, 1996 in Grimentz, Switzerland. This is a joint DESG/Servier partnership on the theme of Improvement of Diabetes Care: from learning concepts to implementation of educational programmes. These two workshops will be held under a slightly different concept to that of previous DESG workshops insofar as participants will, for the most part, be coming from the Servier subsidiaries worldwide. Accompanying people from those subsidiaries will be doctors working closely with Servier. The aim of this meeting should be to strengthen the activities of the DESG and to illustrate to physicians of non-European countries the EASD model which may strengthen diabetes health care.

SPONSORSHIP OF THE DESG
'Les Laboratoires Servier' are most generously continuing the sponsorship of this Study Group until the end of 1997. May we thank the directors Dr. Jean-Philippe Seta and Dr. Didier Halimi for this important collaboration.

We also give many thanks to Mrs. Susanne Hayes of Novo Nordisk for her continuing activities concerning the publications of the various version of the Survival Kit.

Prof. Jean-Philippe ASSAL
President, Diabetes Education Study Group
September, 1996