• Scottish Ambulance Service, UK.
• Emerg Med J. 2015 May 1;32(5):e7.

BackgroundIn Scotland approximately 70% of patients with diabetes treated for a hypoglycaemic event by ambulance clinicians remain at home after treatment. However, many of these individuals experience repeat or subsequent hypoglycaemic events. Current clinical guidance recommends that individuals are advised to follow-up care with their GP, however evidence suggests only a minority make these appointments. The reasons for this are unknown.AimTo investigate the experiences of patients who are attended by ambulance clinicians for a hypoglycaemic emergency.MethodsIn depth interviews undertaken with adults with diabetes who have experienced a hypoglycaemic emergency treated by Scottish Ambulance Service ambulance clinicians. Data was analysed thematically.FindingsTwenty six patients were interviewed. Three key themes were developed. Firstly, an explanation for help seeking behaviour; demonstrating that the patient's misinterpretation or lack of symptoms as well as the inability of friends and relatives to cope can contribute to an ambulance call-out. Secondly, the perceptions of ambulance service care; finding that patients felt care provided was good and dependable and that recovery was predictable. Advice given by ambulance clinicians was found to be inconsistent. Thirdly, the influences on uptake of follow-up care; preferences for follow-up care were influenced by previous experiences of home, hospital and primary care.LimitationsThe study found it hard to recruit younger participants (i.e. 16-25 years). Participants' recollection of events on recovery may have been confused due to problems associated with post hypoglycaemic cognitive impairment.ConclusionMany patients do not perceive immediate hospital care or follow-up care with their diabetes care provider post hypoglycaemic event to be beneficial.RecommendationInterventions aimed at improving self-referral for follow-up care are required to address these perceptions.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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