About the EQUIPD Study

Why do we want to do this study?

People with diabetes who have raised blood sugar level are at increased risk of complications such as sight loss, kidney disease and nerve damage. An insulin pump is a small electronic device that reduces blood sugar by giving insulin throughout the day via a small tube. Since 2008, national guidelines have recommended insulin pumps for people with type 1 diabetes people who have high blood sugar.

Around 90,000 people in England have high blood sugar but do not use an insulin pump. Importantly, insulin pump use varies according to where people live and their age, sex and ethnicity. People with diabetes, healthcare professionals and NHS England have all said that increasing insulin pump use is important.

The National Diabetes Audit (NDA) measures how many people with diabetes receive care recommended by guidelines. The NDA aims to drive changes that improve care by providing feedback to patients, policymakers and clinical teams. Despite giving feedback since 2016, large gaps in insulin pump use remain.

We think that we can increase insulin pump use by supporting specialist diabetes teams (doctors, nurses and others) to act more effectively following NDA feedback. We have developed and tried a programme of workshops, coaching and sessions where teams learn from each other. The programme helps teams to choose actions according to their own circumstances and commit to these actions. The programme will be delivered virtually by the NDA and will be free to the teams.

How is the work funded?

This project is funded by the NIHR Health and Social Care Delivery Research programme (151848). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

What will we achieve?

We will:

  • evaluate whether the support leads to greater change than feedback alone
  • understand how the support is delivered and how teams respond
  • evaluate whether the support is value for money

What will the study involve?

All diabetes teams will be offered the support programme. Participating teams will be randomly assigned to get the support or not during the study. The teams will be able to opt out from the research but still receive the support. We will measure how many people start and stay on the pumps for three months by gathering prescription data. This data is routinely extracted from medical records unless patients opt out. We will compare insulin pump use between those diabetes teams that got the support and those that did not. Immediately after the study, we will give the support to all teams that did not receive it during the study.

To see how those involved deliver and use the programme, we will observe what happens in the virtual workshops, coaching and shared learning meetings. We will read documents that are produced. We will interview people who delivered the support programme, and diabetes team members who did or did not receive the support.

We will describe the cost of delivering and receiving the support and evaluate whether the benefits outweigh the costs.

Our findings will help the NDA decide whether to provide support in the same way in future. Our findings will also help other national clinical audits (e.g. for cancer, heart disease) decide whether to provide similar support to improve patient care.

For study enquiries, please use the form on the Contact tab. If you require further information about data protection, please email dp.officer@northumbria.ac.uk