Evidence map›Paper›PMID 36434593›Full record

ArticleBMC medicine2022

Implementation and delivery of group consultations for young people with diabetes in socioeconomically deprived, ethnically diverse settings.

Chrysanthi Papoutsi, Dougal Hargreaves, Ann Hagell, Natalia Hounsome, Helen Skirrow, Koteshwara Muralidhara, Grainne Colligan, Anne Ferrey, Shanti Vijayaraghavan, Trish Greenhalgh and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.1field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 6 institutions in 1 country.

Chrysanthi PapoutsiNuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK. chrysanthi.papoutsi@phc.ox.ac.uk.
Dougal HargreavesSchool of Public Health, Imperial College London, London, UK.
Ann HagellAssociation for Young People's Health, London, UK.
Natalia HounsomeBrighton and Sussex Medical School, Brighton, UK.
Helen SkirrowSchool of Public Health, Imperial College London, London, UK.
Koteshwara MuralidharaLondon Northwest University Healthcare NHS Trust, London, UK.
Grainne ColliganCentre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Anne FerreyNuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK.
Shanti VijayaraghavanBarts Health NHS Trust, London, UK.
Trish GreenhalghNuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK.
Sarah FinerCentre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
University of Oxford · GBBarts Health NHS Trust · GBImperial College London · GBAssociation for Young People’s Health · GBBrighton and Sussex Medical School · GBQueen Mary University of London · GB

Funding

Health Services and Delivery Research Programme 15/25/20
6 · The paper itself

Abstract

backgroundYoung people with diabetes experience poor clinical and psychosocial outcomes, and consider the health service ill-equipped in meeting their needs. Improvements, including alternative consulting approaches, are required to improve care quality and patient engagement. We examined how group-based, outpatient diabetes consultations might be delivered to support young people (16-25 years old) in socio-economically deprived, ethnically diverse settings.

methodsThis multi-method, comparative study recruited a total of 135 young people with diabetes across two implementation and two comparison sites (2017-2019). Informed by a 'researcher-in-residence' approach and complexity theory, we used a combination of methods: (a) 31 qualitative interviews with young people and staff and ethnographic observation in group and individual clinics, (b) quantitative analysis of sociodemographic, clinical, service use, and patient enablement data, and (c) micro-costing analysis.

resultsImplementation sites delivered 29 group consultations in total. Overall mean attendance per session was low, but a core group of young people attended repeatedly. They reported feeling better understood and supported, gaining new learning from peers and clinicians, and being better prepared to normalise diabetes self-care. Yet, there were also instances where peer comparison proved difficult to manage. Group consultations challenged deeply embedded ways of thinking about care provision and required staff to work flexibly to achieve local tailoring, sustain continuity, and safely manage complex interdependencies with other care processes. Set-up and delivery were time-consuming and required in-depth clinical and relational knowledge of patients. Facilitation by an experienced youth worker was instrumental. There was indication that economic value could derive from preventing at least one unscheduled consultation annually.

conclusionsGroup consulting can provide added value when tailored to meet local needs rather than following standardised approaches. This study illustrates the importance of adaptive capability and self-organisation when integrating new models of care, with young people as active partners in shaping service provision.

trial registrationISRCTN reference 27989430.

Indexed as

Diabetes MellitusAdolescentAdultHumansPatient ParticipationReferral and ConsultationResearch DesignSelf CareYoung AdultComplexityDiabetesGroup consultationsShared medical appointmentsYoung people

Identifiers

PMID36434593
PMCPMC9701006
OpenAlexW4309961765

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.