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G463(P) Adolescent diabetic outpatient clinics – more than just an HbA1c
  1. S Alexander,
  2. L Bath,
  3. M McDonald
  1. Department of Diabetes and Endocrinology, Royal Hospital for Sick Chiildren, Edinburgh, UK

Abstract

Objectives The objective was to audit the four Lothian Adolescent diabetes clinics during June and July 2015 using the Department of Health ‘You’re Welcome’ criteria as a gold standard for excellent outpatient care.

Methods A Paediatric registrar and 6 student nurses gave anonymous questionnaires to patients aged 14–16 years. 79 patients completed questionnaires. The questionnaire was divided into 7 topics using a Likert scale with the option of additional comments.

Results The results were similar from all 4 sites. Clinic locations and times were suitable, with acceptable waiting times at all sites except the Royal Infirmary. Young people did not want to chat to other patients or receive diabetes education whilst waiting. They were happy for student doctors and nurses to be present and there was mixed views regarding seeing the same doctor at each appointment (Table 1).

Abstract G463(P) Table 1

My time

The patients do not regularly look online for diabetes support or education. They would like information regarding online support and social media at clinic and the most commonly used sites were Diabetes UK and Facebook. They would like more general lifestyle advice.

The patients were happy with their transition. They felt equipped to take over from their parents but would like more information and earlier on the adult clinics. The young people felt informed regarding confidentiality but less so of their rights (Table 2).

Abstract G463(P) Table 2

My transition

They felt the clinic environment was comfortable and private but that there was nothing suitable for them to do whilst waiting. The feedback regarding the individual team members was positive but they were not always able to see the team members they needed. They were unsure how to contact the team out of hours and would like clinic reminders via text (Table 3).

Abstract G463(P) Table 3

My team

Conclusions The response regarding the diabetes teams and clinics was exceptionally positive. There was a clear wish for greater autonomy and control in addition to advice and support regarding other aspects of healthcare and lifestyle.

Healthcare outcomes continue to improve in all age categories except adolescents and the death rate amongst 15–19 year olds is now higher than those under 4 years. The second highest cause of death remains suicide. As primary care attendances continue to fall it becomes the responsibility of a tertiary clinic to opportunistically address all the psychosocial and medical needs of a young person. Do this, and the HbA1c will also improve.

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