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Slide no 1 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 12 Congreso Latino Americano de Diabetes 28 September 2004.

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Presentation on theme: "Slide no 1 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 12 Congreso Latino Americano de Diabetes 28 September 2004."— Presentation transcript:

1 Slide no 1 Soren E. Skovlund DAWN Programme Novo Nordisk August Congreso Latino Americano de Diabetes 28 September 2004

2 Slide no 2 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 DAWN Symposium Programme ALAD 2004 The DAWN Programme in the ALAD perspective Antonio Chacra The DAWN Programme in the SACA perspective Susana Campanella The DAWN Worldwide Call to Action Soren E. Skovlund Assessment of psychological well-being – taking DAWN into action Frank Snoek Preliminary results of the DAWN questionnaire in Argentina Juan José Gagliardino Discussion and conclusions for Latin-America Panel

3 Slide no 3 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 The DAWN world-wide call to action for better diabetes care Soren E. Skovlund, Msc,Dgr. Senior Adviser, head Global DAWN Programme Novo Nordisk Denmark

4 Slide no 4 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 Overview The global DAWN (Diabetes Attitudes Wishes and Needs) Study The DAWN Call to Action Regional and national implementation of DAWN

5 Slide no 5 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 The DAWN Programme A Novo Nordisk initiative in collaboration with the International Diabetes Federation and an International Expert Advisory Board Began in 2001 with the DAWN (Diabetes Attitudes Wishes and Needs) study A long-term commitment to improve the health and quality of life for people with diabetes by focusing on the person

6 Slide no 6 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 The aim of the DAWN programme To overcome the psychosocial barriers to health and quality of life through facilitation of concrete initiatives and best practice sharing worldwide

7 Slide no 7 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 DAWN is an expression of the Novo Nordisk vision To defeat diabetes by finding better methods of diabetes prevention, detection and treatment To work actively to promote collaboration between all parties in the health care system in order to achieve our common goals

8 Slide no 8 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 Why the DAWN study? Number of people with diabetes will double in the next 25 years to over 300 million worldwide Today less than 50% of people with diabetes achieve satisfactory control of their blood sugar, despite the availability of effective therapies

9 Slide no 9 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 Objectives of the global DAWN study To understand attitudes wishes and needs of people with diabetes and identify the psychosocial barriers to good treatment outcomes for people with diabetes and provide a framework for concerted action and dialogue between all parties in the healthcare system world-wide

10 Slide no 10 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 Study methodology Structured interviews of: adults with diabetes healthcare providers physicians 550 specialist physicians 500 nurses 600 specialist nurses Australia France Germany India Japan Netherlands Poland Scandinavia Spain UK USA

11 Slide no 11 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 The DAWN study questionnaire Health care provision Personality Diabetes knowledge/beliefs Sociocultural environment Everyday life patterns Psychological health Physical health Diabetes history Effective self-management

12 Slide no 12 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 The DAWN study revealed critical gaps in diabetes care Psychosocial problems and poor diabetes self-management is a worldwide issue Healthcare professionals are not able to offer the needed psychosocial support for people with diabetes

13 Slide no 13 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 Psychological well-being of people in the DAWN study Less than half of the healthcare professionals said they were able to provide adequate psychosocial support 58%42% Good well-being Poor well-being

14 Slide no 14 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 Irrational beliefs delay use of effective diabetes therapy More than half are worried about starting on insulin Half believe that starting on insulin would mean they had failed to manage their disease Only one fifth believe insulin would help them manage their diabetes better More than one third of physicians postpone insulin until “absolutely essential!” Two-thirds use insulin as a threat with their patients

15 Slide no 15 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 The DAWN study suggests a new approach to diabetes Well-being/social support Effective self-management Optimal glycaemic control and quality of life

16 Slide no 16 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 How to translate the DAWN study into ACTION?

17 Slide no 17 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 Translating DAWN into Practice - The 2nd Intl DAWN summit London, November delegates, 31 countries People with diabetes, NGOs healthcare professionals, media and politicians

18 Slide no 18 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 The DAWN world-wide call to action To improve outcomes in diabetes, we must address the people behind the disease

19 Slide no 19 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 Five goals were confirmed for concerted advocacy and action: 1. Enhance communication between people with diabetes and healthcare providers 2. Promote communication and coordination between healthcare providers 3. Promote active self-management 4. Overcome emotional barriers to effective therapy 5. Enable better psychological care for people with diabetes

20 Slide no 20 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 Novo Nordisk can facilitate regional action with DAWN: Best practice sharing world-wide Facilitate broader use of existing tools Workshops, tools, strategies for clinicians Applied research and concrete guidelines Platform for cross-disciplinary dialogue Intl. ambassadorship for policy change

21 Slide no 21 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 Raise awareness and advocacy Mobilise people with diabetes Train healthcare providers Provide practical tools and systems Drive policy and health- care systems change Develop psychosocial research in diabetes The DAWN framework for regional implementation

22 Slide no 22 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 Raise awareness and advocacy Mobilise people with diabetes Train healthcare providers Provide practical tools and systems Drive policy and health- care systems change Develop psychosocial research in diabetes The DAWN framework for regional implementation COPIES AVAILABLE AFTER THIS SYMPOSIUM

23 Slide no 23 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 Raise awareness and advocacy Mobilise people with diabetes Train healthcare providers Provide practical tools and systems Drive policy and health- care systems change Develop psychosocial research in diabetes The DAWN framework for regional implementation LAY PRESS MEDIA EMPOWERING PEOPLE e.g. United States Germany Australia DIABETES PASSPORTS

24 Slide no 24 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 Raise awareness and advocacy Mobilise people with diabetes Train healthcare providers Provide practical tools and systems Drive policy and health- care systems change Develop psychosocial research in diabetes Nationwide TRAIN-THE-TRAINER workshops adapted for local needs DAWN into existing training materials CD-ROM s and Web The DAWN framework for regional implementation

25 Slide no 25 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 Best Practice of training: Poland 3-year nationwide training program STEP 1: Specialists trained to train GPs STEP 2: GPs and 2000 nurses were trained by specialists in integrated medical- psychological approach Regional conferences with speakers from the DAWN International Advisory Board

26 Slide no 26 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 Raise awareness and advocacy Mobilise people with diabetes Train healthcare providers Provide practical tools and systems Drive policy and health- care systems change Develop psychosocial research in diabetes Nationwide TRAIN-THE-TRAINER workshops adapted for local needs DAWN into existing training materials CD-ROM s and Web The DAWN framework for regional implementation

27 Slide no 27 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004

28 Slide no 28 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 The DAWN framework for regional implementation Raise awareness and advocacy Mobilise people with diabetes Train healthcare providers Provide practical tools and systems Drive policy and health- care systems change Develop psychosocial research in diabetes DAWN PATIENT QUESTIONNAIRES database Primary care Centers WHO-5 WB Index in good spir..      active and..      calm and rel..     

29 Slide no 29 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 The DAWN framework for regional implementation The DAWN EXPERIMENT: - ASK - LISTEN 5 MIN - RESPOND - ENCOURAGE Raise awareness and advocacy Mobilise people with diabetes Train healthcare providers Provide practical tools and systems Drive policy and health- care systems change Develop psychosocial research in diabetes

30 Slide no 30 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 The DAWN framework for regional implementation Raise awareness and advocacy Mobilise people with diabetes Train healthcare providers Provide practical tools and systems Drive policy and health- care systems change Develop psychosocial research in diabetes IDF-DAWN GLOBAL PSYCHOSOCIAL DIABETES GUIDELINE PROGRAMME

31 Slide no 31 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 The DAWN framework for regional implementation Raise awareness and advocacy Mobilise people with diabetes Train healthcare providers Provide practical tools and systems Drive policy and health- care systems change Develop psychosocial research in diabetes Clinical and socioeconomic research to evaluate the benefit of the psychological focus

32 Slide no 32 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 How to take action in Latin- America Use DAWN study findings to start dialogue between all local stakeholders in diabetes about how to place the person with diabetes in focus Identify key stakeholders to drive action and local the agreed priority areas for DAWN action Utilise DAWN programme materials, clinical tools, networks and concepts to start initiatives that will benefit large group of people with diabetes Learn from more than 20 other countries who are implementing the DAWN study!

33 Slide no 33 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 What are the priorities for action in Latin-America? 1. Enhance communication between people with diabetes and healthcare providers 2. Promote communication and coordination between healthcare providers 3. Promote active self-management 4. Overcome emotional barriers to effective therapy 5. Enable better psychological care for people with diabetes

34 Slide no 34 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 Thank you Please pick up the Diabetes Voice Special Issue after the symposium For more information: Contact Novo Nordisk DAWN website:

35 Slide no 35 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004

36 Slide no 36 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 Dr. David Matthews (UK) Oxford Centre for Diabetes, Endocr. & Metabolism Dr. Frank Snoek (NL) Vrije Universiteit, Dept. of Medical Psychology Chairman, PSAD study group, EASD Ruth Colagiuri (Aus) VP, Australian Diabetes Educators Association Director, Australian Centre for Diabetes Strategies Dr. Line Kleinebreil (F) DiabCare France, Hôpital Jean Verdier Rüdiger Landgraf MD (G) Medizinische Klinik, Universität München Dr. Hitoshi Ishii (J) Tenri Yorozu Soudanjyo Hospital, Dr. P.H.L.M. Geelhoed (NL) Duijvestijn Haaglandlanden Hospital Richard Rubin (USA) Johns Hopkins University School of Medicine Ib Brorly (DK) Person with type 2 diabetes Dr. Torsten Lauritzen (DK) Aarhus University The DAWN International Expert Advisory Board 2004 DAWN Programme – Reference Slide Kit – © Novo Nordisk

37 Slide no 37 Soren E. Skovlund DAWN Programme Novo Nordisk August 2004 DAWN References Practical Diabetes International, Vol. 19 (1), pp a, The DAWN (Diabetes Attitudes, Wishes and Needs) Study Practical Diabetes International, Vol. 19 (6), pp , 2002 The Oxford International Diabetes Summit: Implications of the DAWN study: 7-8 April 2002, Oxford, UK Practical Diabetes International, July 26th Issue, 2004 The 2nd DAWN International Summit: A worldwide call to action: London, UK Diabetic Medicine, Psychosocial Problems and Barriers to Improved Diabetes Management: Results of the Cross-national Diabetes Attitudes, Wishes and Needs (DAWN) Study, International DAWN Advisory Panel, prov. accepted, Diabetic Medicine, Geelhoed-Duijvestijn, P., Peyrot, M., Skovlund, S., Rubin, R., Matthews, D., Kleinebreil, L., Lauritzen, T., Colagiuri, R., and Snoek, F. "Physician Resistance to Prescribing Insulin: An International Study." Diabetologia, Peyrot, M.,, Matthews, D., Snoek, F., Colagiuri, R., Kleinebreil, L., Rubin, R., Ishi, H., Lauritzen, T., Geelhoed-Duijvestijn, P., and Skovlund, S. "An International Study of Psychological Resistance to Insulin Use among Persons with Diabetes." Diabetologia, Peyrot, M., Rubin, R., and Siminerio, L. "Physician and Nurse Use of Psychosocial Strategies and Referrals in Diabetes." Diabetes, 51 (Sup. 2): A446, Rubin, R., Peyrot, M., and Siminerio, L. "Predictors of Diabetes Self-management and Control." Diabetes, 51 (Sup. 1): A437, 2002 Peyrot, M., Rubin, R., and Siminerio, L. "Physician, Nurse and Patient Perceptions of Diabetes Care." AADE 29th Annual Meeting Program Book, 28: 255, 2002 Peyrot, M., Rubin, R., and Siminerio, L. "The Effect of Initial Response to Diagnosis of Diabetes on Later Adjustment." AADE 29th Annual Meeting Program Book, 28: 256, 2002


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