Evidence map›Paper›PMID 38943014›Full record

Trial reportJournal of general internal medicine2024

Comparative Effectiveness of Patient-Driven versus Standardized Diabetes Shared Medical Appointments: A Pragmatic Cluster Randomized Trial.

Bethany M Kwan, L Miriam Dickinson, Jennifer Dailey-Vail, Russell E Glasgow, R Mark Gritz, Dennis Gurfinkel, Christina M Hester, Jodi Summers Holtrop, Patrick Hosokawa, Angela Lanigan and 14 more

Registry-linked trialAbstract readMulticenter StudyPragmatic Clinical TrialRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of general internal medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03590041 (Invested in Diabetes), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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.

NCT03590041 nacompletednot on this map

Invested in Diabetes: Comparing Patient-Centered Outcomes of Standardized Versus Patient-Driven Diabetes Shared Medical Appointments (PCORI IHS-1609-36322)

TypeinterventionalSponsorUniversity of Colorado, DenverRan2019 to 2022Enrolled1,085ConditionsDiabetes Mellitus, Type 2ArmsStandardized SMA, Patient-driven SMA
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Sustaining Diabetes Shared Medical Appointments After a Pragmatic Trial.Journal of the American Board of Family Medicine : JABFM
    Trial
  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

24 authors.

Bethany M KwanDepartment of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA. bethany.kwan@cuanschutz.edu.ORCID 0000-0002-4013-5618
L Miriam DickinsonDepartment of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
Jennifer Dailey-VailUniversity of Colorado College of Nursing, Aurora, CO, USA.
Russell E GlasgowDepartment of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
R Mark GritzDepartment of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
Dennis GurfinkelAdult & Child Center for Outcomes Research & Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Christina M HesterAmerican Academy of Family Physicians National Research Network, Leawood, KS, USA.
Jodi Summers HoltropDepartment of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
Patrick HosokawaAdult & Child Center for Outcomes Research & Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Angela LaniganAmerican Academy of Family Physicians National Research Network, Leawood, KS, USA.
Donald E NeaseDepartment of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
Andrea NederveldDepartment of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
Phoutdavone Phimphasone-BradyDepartment of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
Natalie D RitchieOffice of Research, Denver Health & Hospital Authority, Denver, CO, USA.
Martha SajatovicDepartments of Psychiatry and Neurology, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Robyn WearnerDepartment of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
Anowara BegumDepartment of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
Madelaine CarterDepartment of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
Thomas CarriganInvested in Diabetes Patient Partners, Aurora, CO, USA.
Barbara ClayInvested in Diabetes Patient Partners, Aurora, CO, USA.
David DowneyInvested in Diabetes Patient Partners, Aurora, CO, USA.
Ramona KorenInvested in Diabetes Patient Partners, Aurora, CO, USA.
Sharon A TrujilloInvested in Diabetes Patient Partners, Aurora, CO, USA.
Jeanette A WaxmonskyDepartment of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA.

Funding

Patient-Centered Outcomes Research Institute IHS-1609-36322
6 · The paper itself

Abstract

backgroundDiabetes self-management education and support can be effectively and efficiently delivered in primary care in the form of shared medical appointments (SMAs). Comparative effectiveness of SMA delivery features such as topic choice, multi-disciplinary care teams, and peer mentor involvement is not known.

objectiveTo compare effects of standardized and patient-driven models of diabetes SMAs on patient-level diabetes outcomes.

designPragmatic cluster randomized trial.

participantsA total of 1060 adults with type 2 diabetes in 22 primary care practices.

interventionsPractice personnel delivered the 6-session Targeted Training in Illness Management (TTIM) curriculum using either standardized (set content delivered by a health educator) or patient-driven SMAs (patient-selected topic order delivered by health educators, behavioral health providers [BHPs], and peer mentors). MAIN MEASURES: Outcomes included self-reported diabetes distress and diabetes self-care behaviors from baseline and follow-up surveys (assessed at 1st and final SMA session), and HbA1c, BMI, and blood pressure from electronic health records. Analyses used descriptive statistics, linear regression, and linear mixed models. KEY

resultsBoth standardized and patient-driven SMAs effectively improved diabetes distress, self-care behaviors, BMI (- 0.29 on average), and HbA1c (- 0.45% (mmol/mol) on average, 8.3 to 7.8%). Controlling for covariates, there was a small, significant effect of condition on overall diabetes distress in favor of standardized SMAs (F(1,841) = 4.3, p = .04), attributable to significant effects of condition on emotion and regimen distress subscales. There was a small, significant effect of condition on diastolic blood pressure in favor of standardized SMAs (F(1,5199) = 4.50, p = .03). There were no other differences between conditions.

conclusionsBoth SMA models using the TTIM curriculum yielded significant improvement in diabetes distress, self-care, and HbA1c. Patient-driven diabetes SMAs involving BHPs and peer mentors and topic selection did not lead to better clinical or patient-reported outcomes than standardized diabetes SMAs facilitated by a health educator following a set topic order. NIH TRIAL REGISTRY NUMBER: NCT03590041.

Indexed as

Diabetes Mellitus, Type 2Self CareShared Medical AppointmentsAdultAgedComparative Effectiveness ResearchFemaleHumansMaleMiddle AgedPatient Education as TopicPatient ParticipationPrimary Health CareSelf-Managementcomparative effectivenessdiabetesintegrated behavioral healthpeer supportpragmatic trialshared medical appointments

Identifiers

PMID38943014
PMCPMC11576683

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

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.