Evidence map›Paper›PMID 38719287›Full record

Trial reportBMJ open2024

Appropriateness and acceptability of continuous glucose monitoring in people with type 1 diabetes at rural first-level hospitals in Malawi: a qualitative study.

Ada Thapa, Stellar Chibvunde, Leah Schwartz, Celina Trujillo, Gina Ferrari, Laura Drown, Apoorva Gomber, Paul H Park, Beatrice Matanje, Amos Msekandiana and 4 more

Abstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Review
  4. 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

14 authors.

Ada ThapaCenter for Integration Science, Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Stellar ChibvundePartners In Health, Neno, Malawi.
Leah SchwartzDepartment of Obstetrics, Gynecology, and Reproductive Biology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Celina TrujilloCenter for Integration Science, Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Gina FerrariCenter for Integration Science, Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Laura DrownCenter for Integration Science, Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Apoorva GomberCenter for Integration Science, Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA.ORCID 0000-0002-9955-9917
Paul H ParkCenter for Integration Science, Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Beatrice MatanjePartners In Health, Neno, Malawi.
Amos MsekandianaKamuzu Central Hospital, Lilongwe, Malawi.
Chiyembekezo KachimangaPartners In Health, Neno, Malawi.
Gene BukhmanCenter for Integration Science, Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Todd RudermanPartners In Health, Neno, Malawi.
Alma J AdlerCenter for Integration Science, Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA aadler2@bwh.harvard.edu.ORCID 0000-0002-6700-3279

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe purpose of this qualitative study is to describe the acceptability and appropriateness of continuous glucose monitoring (CGM) in people living with type 1 diabetes (PLWT1D) at first-level (district) hospitals in Malawi.

designWe conducted semistructured qualitative interviews among PLWT1D and healthcare providers participating in the study. Standardised interview guides elicited perspectives on the appropriateness and acceptability of CGM use for PLWT1D and their providers, and provider perspectives on the effectiveness of CGM use in Malawi. Data were coded using Dedoose software and analysed using a thematic approach.

settingFirst-level hospitals in Neno district, Malawi.

participantsParticipants were part of a randomised controlled trial focused on CGM at first-level hospitals in Neno district, Malawi. Pretrial and post-trial interviews were conducted for participants in the CGM and usual care arms, and one set of interviews was conducted with providers.

resultsEleven PLWT1D recruited for the CGM randomised controlled trial and five healthcare providers who provided care to participants with T1D were included. Nine PLWT1D were interviewed twice, two were interviewed once. Of the 11 participants with T1D, six were from the CGM arm and five were in usual care arm. Key themes emerged regarding the appropriateness and effectiveness of CGM use in lower resource setting. The four main themes were (a) patient provider relationship, (b) stigma and psychosocial support, (c) device usage and (d) clinical management.

conclusionsParticipants and healthcare providers reported that CGM use was appropriate and acceptable in the study setting, although the need to support it with health education sessions was highlighted. This research supports the use of CGM as a component of personalised diabetes treatment for PLWT1D in resource constraint settings. TRIAL REGISTRATION NUMBER: PACTR202102832069874; Post-results.

Indexed as

Continuous Glucose MonitoringDiabetes Mellitus, Type 1AdultBlood GlucoseFemaleHospitals, DistrictHospitals, RuralHumansInterviews as TopicMalawiMaleMiddle AgedPatient Acceptance of Health CareQualitative ResearchBlood GlucoseGeneral diabetesInternational health servicesPUBLIC HEALTHQUALITATIVE RESEARCH

Identifiers

PMID38719287
PMCPMC11086409

What Socratic holds

Textmetadata
LicenceCC BY-NC
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.