people can't possibly be 'not trying hard
enough', so perhaps we should look
more closely at the way that healthcare is
delivered and try different ways to support
people. What many people with diabetes
perceive is that they are failing. This isn't
good for anyone. Living with diabetes is
not just about achieving HbA1c levels
but also about coping with a multitude of
other aspects of diabetes. Quality-of-life
matters as well."
Barnard's aim is to improve the way
healthcare is delivered. To that end, she
and her team have developed KALMOD,
especially to improve what can be
achieved in consultations, for both the
person with diabetes and their HCPs.
"Currently, the HCP chooses for their
patient which therapy, often diabetes
technology, will give them the greatest
benefit from a medical point of view," says
Barnard, "But they do this often without
the context of the wider lifestyle factors
that impact on an individual's ability to use
that treatment or technology in their daily
lives for best effect . It's a matter of getting
the right therapy at the right time, with
the right support to reduce the burden
associated with living with diabetes. The
goal of any therapy is to provide optimal
medical benefits and improved quality of
life. While cost is often used as a barrier
to access to new technologies, in reality
the biggest cost is the device that is not
used or not used well. My team and I are
hoping to move these technology and
treatment decisions away from being
Barnard explains, "We believe if
you can better understand the patient's
needs then you can help them access
the therapy that best meets their needs
in the context of their own life. Some
technologies simply don't work for
some people for all sorts of reasons,
often lifestyle related as well as medical.
And sometimes other things are more
important at this time."
KALMOD is currently in the research
phase and early results are very positive.
Targetted for people with Type 1 diabetes,
a version for Type 2 diabetes is also
underway. "The idea is that people will
be doing this quickly on a tablet in the
waiting room prior to their appointment,"
says Barnard, "then the HCPs can talk
through the results and recommendations
with each person." Once the clinical trials
are complete, KALMOD will be accessible
outside of clinics.
*The Kaleidoscope model of care presents a
novel, holistic, tailored and individualized approach
to healthcare delivery for people with diabetes
through an assessment of an individual's current
regimen, barriers and motivation and available
support resources. The model promotes the
specific needs of individuals with diabetes. These
needs are dynamic, taking a different shape at
different points in time, recognizing and adapting
to the range of care needed. It is a flexible model
that can be applied in different healthcare settings.
Barnard, Lloyd, Dyson, Davies, O'Neil, Naresh,
Lawon, Ziegler, Hold. April 2014.
Would you like to test the system?
Professor Barnard is looking for volunteers to try the KALMOD tool via a secure
website (currently not live, but available for research purposes only). She says,
"We ask you to complete a brief survey, then at the end tell us about your
experience of using the tool and your thoughts about it by filling in a second
short survey. We'd very much like your help!"
To use the KALMOD tool in its pilot stage click on the link below and use the
supplied user name ProfessorKathBarnard and the password K4lm0dP455.
Don't forget email@example.com! Any problems contact Professor
Barnard direct firstname.lastname@example.org @drkathbarnard