Dose Adjustment for Normal Eating (DAFNE) in routine clinical practice: who benefits?

Keen, Andrew; Duncan, Eilidh; McKillop-Smith, A; Evans, Nicholas; Gold, Ann

doi:10.1111/j.1464-5491.2011.03479.x

Cited by 20 publications

(24 citation statements)

References 19 publications

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“…All DSME intervention studies but one (50) (who did not report significance levels) reported significant reductions in DD (35, [70][71][72][73] and in HbA1c when reported (35,71,72). The DSME Intervention studies were pre-post design and five of the six evaluated the DAFNE programme (Dose Adjustment For Normal Eating) and thus are generally more homogeneous which may account for the consistent positive impact on DD across these DSME interventions.…”

Section: Table 1 Characteristics Of Intervention Studiesmentioning

confidence: 99%

The Detection and Management of Diabetes Distress in People With Type 1 Diabetes

et al. 2015

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Diabetes distress (DD) represents a significant clinical burden in which levels of DD are related to both HbA1c and some self-management behaviours. DD is related to, but different from, depression.Differences in DD experienced in people with type 1 and type 2 have been observed. Commonly measured by the Problem Areas in Diabetes Scale and the Diabetes Distress Scale, rates of elevated DD in research study participants range 20-30%. Risk factors for elevated DD in type 1 are a longer duration of diabetes, severe hypoglycaemia, younger age and being female. A systematic review of intervention studies assessing DD identified eight RCTs and nine pre-post design studies. Only three studies targeted DD with the intervention. Intervention types were diabetes self-management education (DSME); psychologically informed self-management and; devices. DSME pre-post studies, namely the DAFNE programme (Dose Adjustment For Normal Eating), produced more consistent improvements in DD and HbA1c at follow up. Psychologically informed self-management were more heterogeneous but several RCTs were effective in reducing DD. Group interventions offered the greatest benefits across intervention designs.

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Section: Table 1 Characteristics Of Intervention Studiesmentioning

confidence: 99%

The Detection and Management of Diabetes Distress in People With Type 1 Diabetes

et al. 2015

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“…The researchers indicated routine adoption of DAFNE might be beneficial for people with poorly controlled diabetes in terms of the reduction of HbA1c and for emotional well-being, when highly motivated diabetes educators are available. It was recommended to further test the programme in other ''real world'' situations where the conditions were different to the context of the study (Keen et al, 2011).…”

Section: Existing Structured Diabetes Education Programmesmentioning

confidence: 99%

Considerations in adopting a culturally relevant diabetes health education programme: An Indonesian example

2017

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“…2 There is a lack of research in the use of low FODMAP dietary intervention in a group setting. This audit was conducted to assess the efficacy and feasibility of providing low FODMAP dietary advice in a group environment.…”

Section: Pth-066 An Audit To Assess Feasibility and Efficacy Of Groupmentioning

confidence: 99%

PTH-066 An Audit To Assess Feasibility And Efficacy Of Group Education For Irritable Bowel Syndrome (ibs) Patients In The Delivery Of Low Fodmap (fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols) Dietary Advice

Kinrade¹,

Twamley²,

Fell³

et al. 2014

Gut

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incomplete resection rates at colonoscopy was noted for such polyps at local units. We hence established a National Clinical Network of specialist expert advisors, meeting every fortnight via videoconference to review endoscopy, radiology, pathology and clinical data of cases referred through specific criteria for complex lesions. We also established a National referral centre (NRC) at Llandough with the requisite skills and expertise in complex Endoscopic Mucosal Resection and Dissection (EMR, ESD) where appropriate polyps that met the referral criteria after a Network Multidisciplinary Team meeting discussion (NMDT) could undergo advanced therapy. An NMDT and NRC pilot was established in Oct 2011 to offer the opportunity to access expert opinion and discussion of therapeutic options for Welsh participants of the BCSP. We present our preliminary results. Methods Referral criteria for complex polyps were agreed based on a composite of site, size, morphology and accessibility. Polyps satisfying the criteria were referred to the NMDT electronically along with relevant images and video. Depending on outcomes of NMDT discussion participants were given the option of accessing local surgery or travelling to the NRC for therapeutic endoscopy. Over a 2 year period, 140 referrals were made from 14 different welsh BCS centres to the NMDT. Results The various management decisions taken in 126 benign complex polyps and the 14 cancers detected is illustrated in fig 1. Polyps that had incomplete resection (22) often had piecemeal EMR or repeated attempts at EMR at LAC causing failure of lifting in polyps. It is noteworthy that in the first 1 year of NMDT and NRC establishment;16 such cases were referred in contrast to 6 in the subsequent year with most cases in the 1st year needing surgery. This is an encouraging trend as awareness through discussion in the NMDT has streamlined management and decreased the incidence of incomplete resections allowing definitive management in the first instance and reduction in inappropriate referral to surgery for benign disease. Conclusion Establishing a clinical network for standardised decision making for complex polyps appears to have a significant effect on clinical outcomes.

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Dose Adjustment for Normal Eating (DAFNE) in routine clinical practice: who benefits?

Abstract: These results indicate that Dose Adjustment for Normal Eating delivered in routine clinical practice is associated with a range of benefits and that certain clinical and psychosocial characteristics are associated with better outcomes.

Cited by 20 publications

References 19 publications

The Detection and Management of Diabetes Distress in People With Type 1 Diabetes

The Detection and Management of Diabetes Distress in People With Type 1 Diabetes

Considerations in adopting a culturally relevant diabetes health education programme: An Indonesian example

PTH-066 An Audit To Assess Feasibility And Efficacy Of Group Education For Irritable Bowel Syndrome (ibs) Patients In The Delivery Of Low Fodmap (fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols) Dietary Advice

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