Can resilience strategies help with diabetes management?

To err is human…, but the proactive creation of resilience strategies to reduce the likelihood of error is human too.

Resilience strategies are those things we do to help us avoid error and recover from it. For example, this might be something like putting your umbrella by the front door so its not forgotten when you leave the house, setting a phone alarm so an appointment is not missed, checking that you have your keys before leaving so you’re not locked out, and so on. Until recently no one has given this class of behaviours a common name, and at UCL we have turned research efforts towards understanding these behaviours and started to think about its different applications.

Can a spoonful of resilience help the medicine go down?” is a title of a paper that is currently in press for BMJ Quality & Safety. In this viewpoint paper we consider the application of resilience strategies to the problem of people forgetting to take their medication – this is a huge problem that has big financial and healthcare costs, and it is under-researched.

Patients already adopt strategies to help them cope with adherence, e.g. setting reminders of when to take medication on their phone, having pills with dinner, and leaving medication in a place where they’ll see it as part of their daily routine. In our paper we propose studying these strategies more closely so we can understand and share suitable ones for people who would benefit from them.

One of the nice things about this approach is that we turn to the community for the answers and seek to share the most useful practices. Therefore, the community is supporting itself and will have real solutions for real problems they have in common. Even outside of medicine we do not always work out the best approach to an issue ourselves and sometimes we can benefit from the advice of others. For example, when my girlfriend and I first met we lived in separate places, I was frustrated because I would often wash my clothes and then forget it in the washing machine so I’d need to do it again. She suggested leaving out the laundry basket on the floor, or a tea towel in a telling place, so that it would remind me there’s stuff in there. It worked, no more forgetting (well, at least until my mum came round and tidied away the laundry basket). But the point is that we can share these strategies, improve practice and reduce error.

Could this approach be turned to benefit the diabetes community too?

One of the things that got me interested in this application is that someone at my girlfriend’s work puts her insulin pen in her lunch box, so she has it at the right time everyday. I thought this was a simple but clever strategy. It’s also a good example of a resilience strategy; it simplifies her life and reduces the likelihood of an error. I imagine that other people with diabetes might make simple mistakes every now and then too (we all do it), or maybe frustrating and fairly frequent mistakes like my washing machine example. I think that the same community could have simple and clever strategies that they could share with each other for reducing error and making life easier. We’re only just starting out with this research and we would love to hear your thoughts.

We are collecting resilience strategies and errors through Errordiary – you can either tweet including the hashtags #errordiary or #rsdiary depending on what you are posting, or you can post directly through the website. Whatever way you post, we suggest using the tag ‘#diabetes’ in the post so people can search for this string of letters on the website and find all the posts related to diabetes.

We are also recruiting for focus groups that will take place soon at UCL’s main campus, if you live in and around London and want to take part we would love to hear from you. More information can be found here: The focus groups were help and went well.

The survey is open and their is a prize pot of £150 to give away! Fill it in here.

A big Errordiary competition is coming soon (15th Oct); subscribe to the Errordiary mailing list to be one of the first to find out about these events.


3 responses to this post.

  1. Reblogged this on chi+med blog and commented:
    If you have diabetes what clever strategies have you developed that might help you to remember your medication? Want to share them with other people with diabetes and help research? Via a focus group in London CHI+MED researchers are looking to learn more from people with diabetes about the types of ‘resilience strategies’ that they use to avoid error.

    “One of the nice things about this approach is that we turn to the community for the answers and seek to share the most useful practices. Therefore, the community is supporting itself and will have real solutions for real problems they have in common.”

    The focus group takes place next Tuesday 24 September from 6pm-8pm with registration at 5.30pm. More details here on the Errordiary project page

    Errordiary is an offshoot from the CHI+MED project, and it looks both at everyday error and the resilience strategies people develop to prevent these mistakes, ie to make them more resilient to error – classic examples would include shopping lists so you remember to buy everything you wanted to, and leaving your umbrella by the door so that you take it with you when you leave the house the next day.


  2. […] you’re a person with diabetes there’s one more space on the workshop tonight, on how resilience strategies can help people with diabetes […]


  3. […] Blog post – Can resilience strategies can help with diabetes management? […]


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