Health & Primary Care

Biography

Dr Debbie Wake is a Senior Lecturer and Consultant Physician at University of Dundee/ NHS Tayside (diabetes/ general endocrinology/ osteoporosis). Her research interests include informatics and new technology approaches to patient care, management and education. Further research interests include understanding associations between diabetes and psychiatric disease. Previous research experience is in the area of steroid metabolism in human obesity and diabetes (PhD- 2006) and clinical aspects of diabetes management.

Debbie coordinates the undergraduate teaching in diabetes and endocrinology at the University of Dundee, is programme director for the MSc Quality diabetes care programme and clinical lead for the PG cert/Dip/ MSc Diabetes Care, Education and Management, part of the Kuwait Scotland eHealth Innovation Network. She previously developed an online distance learning MSc programme in Internal Medicine (2011) for the University of Edinburgh and Royal College of Physicians.

Debbie also has an active role in public health communication. She is a regular contributor to radio health programming, was previously resident doctor on Scottish Televisions flagship show 'The Hour', and was a health columnist The Scotsman newspaper for many years. She developed and produced the first medical podcast series in the UK (Dr Pods Healthcast) in 2005, and has also produced and presented videos and webstreams for doctors.net and NES (NHS Education Scotland). She provides clinical support for the innovative mydiabetesmyway patient portal and website - where patients can access their own clinical data and find educational resources on-line.

Abstract

Background: My Diabetes My Way (MDMW) is the NHS Scotland website for people with diabetes and their carers. It consists of an interactive information website and electronic personal health record (ePHR) available to the 291,981 people with diabetes in Scotland.  We aimed to analyse the impact of records access on clinical process outcomes.

Methods: We matched patients by age, gender, type of diabetes, duration, treatment and socioeconomic status. We analysed routinely collected clinical data on HbA1c, cholesterol, creatinine, blood pressure and BMI. Results were analysed in groups: type 1; type 2 on insulin; type 2 not on insulin.

Results: By September 2017, 15,575 people had logged in to access their records. 3,120 had 3+ years of follow-up since first login. There was a reduction in HbA1c in all active users (p<0.001), with type 2 patient not treated with insulin (n=1,599) showing most significant and sustained changes. The intervention cohort reduced from 60.5 to 54.1 mmol/mol (females) and 60.2 to 53.8 mmol/mol (males) within 1 year, while the matched cohort increased from 57 to 57.2 mmol/mol (females) and remained at 57.2 mmol/mol (males) during the same period. Intervention patients remained 2.9 mmol/mol (females) and 3.4 mmol/mol (males) below their matched counterparts after 3 years.

Conclusion: MDMW is an effective low-cost population-based self-management intervention. When extrapolated across a large population, MDMW may offer significant cost savings through reduction of long-term complications and treatmens. MDMW is currently being adapted to work with other clinical systems and conditions, with releases in Somerset and London during 2017.