![](https://communityandhealth.dev.lincoln.ac.uk/files/2020/06/Vanessa-Botan-300x232.jpg)
A study which investigated the effects of an information booklet-based intervention, ‘Hypos can strike twice’, on recurrent hypoglycaemic attendances by ambulance services (Ambu-HS2) features in the latest NIHR alert
She was invited to present at the ACPIC as the winner of the Highest Quality Research prize at the 999 EMS Research Forum conference in 2021.
The study used a non-randomised stepped wedge-controlled design, where the intervention, which consisted in handing out the leaflet to patients following a hypoglycaemic event, was introduced at different times (steps) in different areas (clusters) in the East Midlands region of the UK. Analysis using a generalised linear mixed model showed a reduction in the number of repeat attendances in the final step of the intervention when compared to the first (OR: 0.50, 95%CI: 0.33-0.76, p=0.001). This was supported by an interrupted time series analysis which showed a significant decrease in repeat ambulance attendances for hypoglycaemia relative to the pre-intervention trend (p=0.008). The quality of care, as measured by a hypoglycaemia care bundle increased significantly to from 63% of attendances in the period prior to the intervention to 71% of attendances during the intervention period (p<0.001).
The ‘Hypos can strike twice’ intervention had a positive effect on reducing numbers of repeat attendances for hypoglycaemia and in achieving the hypoglycaemia care bundle. The study supports the wider use of this intervention to prevent future attendances for recurrent hypoglycaemic events and it re-iterates the importance of informing and educating diabetes patients about the recurrent risks of hypoglycaemia to prevent future episodes. The study has implications for the development of future interventions focusing on providing the necessary tools to patients that can help them to ‘live independently and for longer’, in line with the NHS Long Term Plan.
For further details of the study please see the recording of the presentation given at the ACPIC and the published article: Botan, V., Law, G. R., Laparidou, D., Rowan, E., Smith, M. D., Ridyard, C., … & Siriwardena, A. N. (2021). The effects of a leaflet‐based intervention, ‘Hypos can strike twice’, on recurrent hypoglycaemic attendances by ambulance services: A Non‐Randomised Stepped Wedge Study. Diabetic Medicine, e14612.