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Tuesday, 13 January 2015

Ljubljana – a splendid place to do some training!

Ljubljana town centre
6am flight from Manchester to Ljubljana, Slovenia, to deliver three days training on the identification and management of depression in patients with diabetes.

The trip was organized by Dialogue on Diabetes and Depression (DDD)(Sartorius and Cimino 2012), who invited Linda Gask (Emerita Professor of Primary Care Psychiatry, University of Manchester), Clare Baguley (Programme Manager, Psychological Professions Network, Health Education North West) and myself to develop and deliver a training programme, focusing on clinical skills development, for family physicians in Slovenia.

DDD, an international collaboration addressing challenges of comorbid diabetes and depression, suggest that up to 30% of patients with diabetes also have depression, with over half of these patients reaching diagnostic criteria for major depression. The inter-relationship between diabetes and depression is complex, but co-morbid depression worsens outcome for diabetes, and recent literature from the US suggests that managing depression effectively can improve diabetes outcomes.

The goal of DDD, to improve outcomes of patients with co-morbid diabetes and depression, have been endorsed by a number of international and national non-governmental organisations, and its activities include the coordination of research, the development of training materials, the delivery of symposia and training courses, the production of reviews of knowledge and the evidence-base, as well as the facilitation of collaboration around the prevention or reduction of problems of comorbid diabetes and depression among countries, networks, and experts.

Linda and I have been involved in DDD for a number of years (Chew-Graham 2014), but this was the first programme we have delivered outside England. We were impressed that 18 family physicians attended and participated for two and a half days of discussion and role-play. During breaks, we learned that family physicians work under similar pressures to me as a UK GP, but have additional work-load such as providing medical care to large nursing homes, providing urgent care to low population rural areas, where farming accidents are common, or delivering sexual health services to large student populations. Certainly all challenges that I am spared. Combined with teaching responsibilities, they described little time for their families.

The doctors participated enthusiastically in the role-plays and reflected that this way of learning was challenging, hard work, but definitely a good way of learning. A number of attendees committed to rolling out the training in their practices and their teaching and training roles – so one of the DDD objectives for our programme, to ‘train the trainers’ was met.

Clare, Linda and Carolyn working hard
Linda, Clare and I have been invited to run a session at the International Diabetes Federation in March 2015 (in London), so reaching an audience of clinicians and academics with a focus on diabetes.

For the Research Institute, this experience and expertise will be extremely useful in my contribution to the ENHANCE study.

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