Important outcomes for patients with chronic health conditions include quality of life, as well as quality of health. Professor Bradley’s research has illustrated the consequences that chronic health conditions and their treatments can have for quality of life, as well as quality of health, resulting in wide-ranging impacts for patient health and quality of life, health services and the economy.

Improving patient health and wellbeing

Professor Bradley has developed many questionnaires including three main types: quality of life questionnaires for specific health conditions; treatment satisfaction questionnaires for specific health conditions; and generic wellbeing questionnaires. These questionnaires have changed our understanding of how health conditions such as diabetes effect outcomes of importance to patients, and have guided changes to treatment.

The questionnaires have been validated and licenced for use with many patient groups, including those with diabetes, HIV, eye diseases and kidney failure. The questionnaires cover many languages and are used widely by clinicians and clinical students around the world.

Developing DAFNE

Though Bradley’s research applies to many chronic health conditions, the significance of its impact is particularly clear for diabetes as it identified the importance of prioritising dietary freedom in diabetes treatments alongside efforts to control blood glucose levels: this led to the development of the DAFNE (Dose Adjustment For Normal Eating) programme for people with type 1 diabetes.

Bradley’s research found that whilst diabetes has wide-ranging implications for health, the aspect of diabetes that patients find most challenging is not having the freedom to eat as they wish. Effective treatment for type 1 diabetes involves a careful balance of diet, exercise and insulin injections in order to manage blood glucose levels. Bradley’s research was pioneering, highlighting for the first time that it was the dietary restrictions imposed on diabetes patients that had the most impact on their quality of life, and not the need to inject insulin, as had been previously thought.

The NICE guidelines cite research conducted by Bradley and others showing the cost effectiveness of DAFNE, and its benefits for health and wellbeing, compared to other similar programmes. The DAFNE training programme is available in the UK, the Republic of Ireland, Australia, New Zealand, Singapore and Kuwait. In the UK, approximately 3,000 type 1 diabetes patients graduate from the DAFNE programme each year resulting in significant savings to the NHS.