Adding psychology to the diabetes service ‘new patient’ pathway: an evaluation

Abstract

Promotion of psychology as an integrated aspect of the diabetes team has been encouraged, with the aims of: reducing stigma felt by service users accessing this aspect of the MDT, allowing for a biopsychosocial overview of patient care, and timely advising on appropriate signposting and onwards referral where necessary. To this end, a new care pathway was trialled, with psychology appointments offered as the third step in a new nurse and dietitian-led clinic structure. For a five-month trial period, all new patients (newly diagnosed or new to the service, n=30) were allocated a 30-minute-long remote psychology assessment appointment. The attendance rate was 66.7% and comparable with traditional opt-in psychology appointments. Attendance at psychology appointments was not influenced by diabetes type, however patients were more likely to attend if they were female or of British ethnicity. The trial suggested that psychology appointments can be integrated into the preliminary assessment and annual review system without the need for specific referral. Such assessments can offer space for patients to reflect on their experience of living with diabetes and the identification of any psychosocial support needs, enabling timely information sharing and referral for support within and beyond the MDT. Further evaluation is necessary to ascertain whether integrated psychological assessments in the usual care pathway can promote better awareness of, and engagement with, psychology whilst patients are under the care of the diabetes team.