Ambulance "Hypos can Strike Twice" (Ambu-HS2) Study (Version 1.0)

  • Research type

    Research Study

  • Full title

    Effect of implementing an ambulance clinician delivered hypoglycaemia intervention (‘Hypos can strike twice’) on repeat ambulance calls, attendances and transportation to hospital: non-randomised stepped wedge and process evaluation.



  • Contact name

    A. Niroshan Siriwardena

  • Contact email

  • Sponsor organisation

    University of Lincoln

  • Identifier

    NCT04243200, Identifier

  • Duration of Study in the UK

    1 years, 0 months, 1 days

  • Research summary

    This study will assess effectiveness of the “Hypos can strike twice” intervention on people with diabetes experiencing hypoglycaemia (or “hypo”, meaning low blood sugar). The intervention should help prevent recurrence of “hypos”, improve patients’ future health, reduce calls to ambulance services and thus reduce NHS pressures and costs.
    Hypoglycaemia affects increasing numbers of people with diabetes. It is a side effect of treatment with insulin or certain tablets, where blood glucose (sugar) falls causing the brain to malfunction. In mild cases this can lead to sweating, drowsiness and confusion; in more severe cases, coma can occur needing medical assistance for recovery, and if prolonged can be fatal. It results in 1% of calls to ambulance services.
    The “Hypos can strike twice” intervention involves ambulance staff providing treatment to patients experiencing hypos and advising them to access follow-up care by their GP/specialist diabetes team. This is backed up by giving patients a “Hypos can strike twice” information booklet which they can read when they recover.
    Universities of Lincoln and Leicester are working with East Midlands Ambulance Service NHS Trust and patient groups on this study. The “Hypos can strike twice” intervention has now been implemented by ambulance services in Leicester, Northamptonshire, Nottinghamshire, Derbyshire and Lincolnshire from October 2018-May 2019.
    We will analyse data from the ambulance services before, during and after the introduction of the ‘Hypos can strike twice’ intervention to evaluate the effect of the intervention on repeat ambulance calls and attendances for hypoglycaemia and the costs and consequences of implementing it. We will also interview/survey ambulance staff who provided the intervention and patients who received it, to understand how and why it works (or does not) and how, if it works, it could be scaled up over a larger geographical area. The duration of this study is 1 year.

  • REC name

    Yorkshire & The Humber - Leeds West Research Ethics Committee

  • REC reference


  • Date of REC Opinion

    2 Mar 2020

  • REC opinion

    Favourable Opinion

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