Title: DAWN call to action
Goal 1: Improving communication between people with diabetes and healthcare professionals.
Goal 2: Improving team-based care and communication between healthcare professionals.
Goal 3: Providing individual support for more active self-management and a healthier lifestyle.
Goal 4: Overcoming psychosocial barriers to optimal therapy, in both patients and HCPs:
Goal 5: Enabling HCPs to assess and address patients’ needs for psychological support and treatment:
The findings of the DAWN™ study prompted the identification of five goals that form the DAWN™ Call to Action. The essence of DAWN™, it was developed at the first two DAWN™ Summits in 2002 and 2003, and has won endorsement from diabetes organisations worldwide. The DAWN™ Call to Action defines the key action areas of DAWN™:
Understanding and addressing psychosocial problems needs effective communication between doctor and patient. People with diabetes need to be supported in taking responsibility and in conveying their medical and social needs. HCPs should develop their skills in motivating and empowering patients to become more active partners in the relationship.
Effective management of a condition as complex as diabetes requires input from a wide range of medical professionals – primary care doctor, diabetes specialist, nurse, dietician, ophthalmologist, podiatrist, psychologist and sometimes other specialists. Because it is a long-term, chronic condition, the skills of many of these HCPs will be needed as part of a coordinated, multidisciplinary team. Each member should be aware of the importance of dialogue between them, and be guided by a strategy to ensure a coherent, integrated approach to optimising treatment for the individual patient.
The success of the diabetes care team in motivating and supporting active self-management is central to achieving effective care and good outcomes. HCPs should take the patient’s individual circumstances, needs, resources and problems into account when creating treatment plans, since this is essential if they are to be followed effectively.
HCPs should be aware of the value of ensuring rather than postponing effective treatment at an early stage of diabetes, in delaying or preventing the onset of complications. Acting in partnership, they should make sure that patients have the information and support needed to make informed decisions about the reasons for intensifying treatment. This means that HCPs should keep themselves and patients fully informed about the diabetes treatment options that would best suit individual lifestyles and treatment needs.
While many people with diabetes cope with it well and live normal, healthy lives, DAWN™ studies have shown that many others suffer emotional stresses and do not benefit from even basic psychosocial support. The problem is not just one of access to specialist psychologist support. Instead it is vital that HCPs in primary care should be more aware of psychosocial problems and given the information and training to be able to detect them. In many cases they are then able to provide the level of support needed to overcome the problem, or otherwise to refer patients for specialist psychological counselling and support.