The impact of a validated structured education programme on anxiety and depression in patients with type 1 diabetes
Published Date: 07th October 2020
Publication Authors: Sullivan H, Westall S, Jackson J, Cairns J, Cardwell J, Bujawansa S, McNulty S, Furlong NJ, Narayanan RP, Hardy KJ
Background and Aim
People with type 1 diabetes experience greater degrees of anxiety and depression than the general population. The Hospital Anxiety and Depression Scale (HADS) questionnaire can evaluate this. As part of a local, validated structured education programme for people with type 1 diabetes, baseline and endpoint measurements of anxiety and depression were measured using the HADS questionnaire. Scores of ≥8 on HADS‐A (anxiety component) or HADS‐D (depression component) indicate potential cases of anxiety or depression respectively. Scores ≥15 indicate severe cases.
Methods
People with type 1 diabetes who attended structured education completed the HADS questionnaire before and after structured education. Data from the questionnaires were analysed in Excel with the ‘Analysis ToolPak’.
Results
A total of 51 patients, mean age 45 (SD 16), completed baseline and endpoint questionnaires. At baseline, 41% of patients scored ≥8 on HADS‐A (4% ≥ 15) and 13% on HADS‐D (2% ≥ 15). After the course, 31% of patients scored ≥8 on HADS‐A (4% ≥ 15), 18% on HADS‐D (2% ≥ 15). The mean score for HADS‐A went from 6.6 to 6.0 and for HADS‐D went from 4.4 to 4.0. This was not statistically significant.
Conclusions
Structured education did not have a statistically significant impact on anxiety or depression. The fact remains that anxiety and depression are highly prevalent among people with type 1 diabetes. At St Helens Hospital, we are trialling the integration of primary care psychological support (with MindsMatters) into our diabetes education programmes. In liaison with our colleagues in mental health, we are developing pathways towards tailored early access to local primary and secondary care mental health, substance misuse and psychology services for patients with severe anxiety or depression related to their diabetes or otherwise.
Sullivan, H; Westall, SJ; Jackson, J; Cairns, J; Cardwell, J; Bujawansa, S; McNulty, S; Furlong, N; Narayanan, RP; Hardy, K. (2020). The impact of a validated structured education programme on anxiety and depression in patients with type 1 diabetes. Diabetic Medicine. 37 (S1), 99-100