A team in NHS Grampian developed a brief, guided self-help programme
designed to improve glycaemic control and alleviate anxiety and
depression in people struggling to manage type 2 diabetes. ACT
Now! consists of between 5-8 appointments, a participant manual
and web-based support. The web support incorporates five core
modules that promote key self-management behaviours, and three
optional modules for those experiencing significant levels of anxiety, depression, or emotionally-driven eating.
All modules contain a mixture of video, audio and text material that aim to reinforce weekly discussion topics,
provide patient stories, and deliver top tips from experts in the topic areas. Results showed improvement
in all areas for participants, including glycaemic control, and anxiety and depression levels fell significantly
from baseline to follow-up, as did diabetes-related distress. Participants increased their walking markedly.
Despite regular appointments and good quality education, about half of people with type 2 diabetes do not
achieve recommended levels of glycaemic control. Markedly changing complex, long-established lifestyle
behaviours that influence glycaemic control and health outcomes, and adhering to treatment regimens that
may induce significant side effects can be extremely challenging. Clinical and subclinical anxiety and depression
are common, and are associated with poorer glycaemic control. Research indicates that treating anxiety and
depression alone does not lead to better diabetes control. Prior to this project there were not any specific
guided self-help programmes available for people with Type 2 diabetes in NHS Grampian, or across the UK.
To create an intervention that consisted of a small number of 1:1 appointments, a participant and therapist
manual, and a web-based resource. To engage a number of primary care practices and the local specialist
diabetes outpatient service. To recruit 30 people with type 2 diabetes who meet pre-specified criteria.
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