Development of a complex intervention to support patients managing cystic fibrosis diabetes

Objectives: Cystic fibrosis diabetes (CFD) is the most common co-morbidity affecting nearly half of adults with cystic fibrosis over 30 years. Contrary to UK clinical guidelines there are currently no self-management education programmes for people with CFD. The aim of this paper is to describe the development of a self-management education programme for people with CFD. Methods: this study was guided by the Medical Research Council framework for developing and evaluating complex interventions. Programme development took part in three phases: identifying the evidence base, identifying/developing theory, and modelling process and outcomes. A stakeholder development group, consisting of expert healthcare professionals and people with CFD, were actively involved in the development of this intervention. Results: Together with the stakeholder development group, we developed a self-management education programme for people with CFD. The MAGIC (managing abnormal glucose in CF) programme consists of four web-based modules: CF beginner, CF improver, CF advancer and CF wizard and is designed as a patient focussed, staged approach to learning. The MAGIC programme was highly regarded by the participants who reviewed it and all identified technological problems, omissions, errors and comprehension difficulties were addressed before face validity was established. Conclusions: The MRC framework was successfully applied to develop the MAGIC programme, a unique web-based self-management education programme for people with CFD. It is grounded in evidence generated from a qualitative systematic review, qualitative interviews and shared experiences of people with CFD and healthcare professional expert in the management of CFD. Practice implications: With improvements in survival observed in the CF population it is imperatives that resources are available to support the effective management of CFD effective. The MAGIC programme was well received by individuals with CFD. It requires further adaptations prior to further studies to demonstrate its efficacy for use in clinical practice.