Educational group visits for the management of chronic health conditions: A systematic review

Quiñones, Ana; Richardson, Jeannette; Freeman, Michele; Fu, Rochelle; O’Neil, Maya; Motu’apuaka, Makalapua; Kansagara, Devan

doi:10.1016/j.pec.2013.12.021

Cited by 45 publications

(50 citation statements)

References 92 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…343,344 In line with the 'best fit framework', 345,346 these study reports were sufficiently generic to be used as a source of an 'analytical framework' (Figure 56) for examining group care approaches during the perinatal period.…”

Section: Results Of Realist Synthesis: What Work For Whom?mentioning

confidence: 83%

A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression

Morrell

Sutcliffe

Booth

et al. 2016

Health Technol Assess

105

View full text Add to dashboard Cite

A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression C Jane Morrell, 1 * Paul Sutcliffe, 2 Andrew Booth, 3 John Stevens, 3 This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full HTA archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hta. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Technology Assessment journalReports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Care Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hta This reportThe research reported in this issue of the journal was funded by the HTA programme as project number 11/95/03. The contractual start date was in November 2012. The draft report began editorial review in August 2014 and was accepted for publication in June 2015. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HTA programme or the Department ...

show abstract

Section: Results Of Realist Synthesis: What Work For Whom?mentioning

confidence: 83%

A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression

Morrell

Sutcliffe

Booth

et al. 2016

Health Technol Assess

105

View full text Add to dashboard Cite

show abstract

“…We identified a framework from a review entitled Group Visits Focusing on Education for the Management of Chronic Conditions in Adults: A Systematic Review. 42 This review was intended as a 'companion piece' to a SMA review conducted by the Durham Evidence-based Synthesis Program led by Edelman. 18 The SMA review focuses on visits led by a physician or other prescribing provider during which individual-level changes in management plan can be made and, thus, fully corresponds to the scope of our own review.…”

Section: Setting Of Interventionmentioning

confidence: 99%

“…In contrast the review from which we derived the best-fit framework 'focuses exclusively on literature that tests the effectiveness of group visits that have an emphasis on health education and are led by facilitators, including but not limited to non-prescribing health professionals such as nurses, dietitians, and physical therapists'. 42 Nevertheless, it fulfils the forgiving selection criterion for identifying a conceptual framework as specified by the 'best fit' method. A sample data extraction form is available in Appendix 3.…”

Section: Setting Of Interventionmentioning

confidence: 99%

“…A further seven reviews 47,49,51,[53][54][55]87 focused on one specific condition [in all bar one instance this condition was diabetes, with the exception being the review by Slyer and Ferrara 54 (heart failure)]. Two of the remaining reviews 42,50 were broadly coterminous with our own review, focusing on chronic disease in adults (however, we also included children and adolescents). Only two reviews 18,52 covered the exact same population as our review, namely patients of any age group with chronic disease/chronic medical conditions.…”

Section: Populationsmentioning

confidence: 99%

“…42,47,51 A further five reviews had a scope for the intervention that was broader than group clinics: for four of these reviews [48][49][50]54 this focus was labelled 'group visits' and for the remaining review 52 this was 'group care'. Two reviews 18,55 focused on SMAs and two reviews targeted GMVs; 53,57 both of these labels were considered coterminous with our own.…”

Section: Interventionsmentioning

confidence: 99%

See 2 more Smart Citations

What is the evidence for the effectiveness, appropriateness and feasibility of group clinics for patients with chronic conditions? A systematic review

Cantrell

Preston

Chambers

et al. 2015

Health Serv Deliv Res

View full text Add to dashboard Cite

BackgroundGroup clinics are a form of delivering specialist-led care in groups rather than in individual consultations.ObjectiveTo examine the evidence for the use of group clinics for patients with chronic health conditions.DesignA systematic review of evidence from randomised controlled trials (RCTs) supplemented by qualitative studies, cost studies and UK initiatives.Data sourcesWe searched MEDLINE, EMBASE, The Cochrane Library, Web of Science and Cumulative Index to Nursing and Allied Health Literature from 1999 to 2014. Systematic reviews and RCTs were eligible for inclusion. Additional searches were performed to identify qualitative studies, studies reporting costs and evidence specific to UK settings.Review methodsData were extracted for all included systematic reviews, RCTs and qualitative studies using a standardised form. Quality assessment was performed for systematic reviews, RCTs and qualitative studies. UK studies were included regardless of the quality or level of reporting. Tabulation of the extracted data informed a narrative synthesis. We did not attempt to synthesise quantitative data through formal meta-analysis. However, given the predominance of studies of group clinics for diabetes, using common biomedical outcomes, this subset was subject to quantitative analysis.ResultsThirteen systematic reviews and 22 RCT studies met the inclusion criteria. These were supplemented by 12 qualitative papers (10 studies), four surveys and eight papers examining costs. Thirteen papers reported on 12 UK initiatives. With 82 papers covering 69 different studies, this constituted the most comprehensive coverage of the evidence base to date. Disease-specific outcomes – the large majority of RCTs examined group clinic approaches to diabetes. Other conditions included hypertension/heart failure and neuromuscular conditions. The most commonly measured outcomes for diabetes were glycated haemoglobin A1c(HbA1c), blood pressure and cholesterol. Group clinic approaches improved HbA1cand improved systolic blood pressure but did not improve low-density lipoprotein cholesterol. A significant effect was found for disease-specific quality of life in a few studies. No other outcome measure showed a consistent effect in favour of group clinics. Recent RCTs largely confirm previous findings. Health services outcomes – the evidence on costs and feasibility was equivocal. No rigorous evaluation of group clinics has been conducted in a UK setting. A good-quality qualitative study from the UK highlighted factors such as the physical space and a flexible appointment system as being important to patients. The views and attitudes of those who dislike group clinic provision are poorly represented. Little attention has been directed at the needs of people from ethnic minorities. The review team identified significant weaknesses in the included research. Potential selection bias limits the generalisability of the results. Many patients who could potentially be included do not consent to the group approach. Attendance is often interpreted liberally.LimitationsThis telescoped review, conducted within half the time period of a conventional systematic review, sought breadth in covering feasibility, appropriateness and meaningfulness in addition to effectiveness and cost-effectiveness and utilised several rapid-review methods. It focused on the contribution of recently published evidence from RCTs to the existing evidence base. It did not reanalyse trials covered in previous reviews. Following rapid review methods, we did not perform independent double data extraction and quality assessment.ConclusionsAlthough there is consistent and promising evidence for an effect of group clinics for some biomedical measures, this effect does not extend across all outcomes. Much of the evidence was derived from the USA. It is important to engage with UK stakeholders to identify NHS considerations relating to the implementation of group clinic approaches.Future workThe review team identified three research priorities: (1) more UK-centred evaluations using rigorous research designs and economic models with robust components; (2) clearer delineation of individual components within different models of group clinic delivery; and (3) clarification of the circumstances under which group clinics present an appropriate alternative to an individual consultation.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

show abstract

Social network interventions to support cardiac rehabilitation and secondary prevention in the management of people with heart disease

Purcell

Dibben

Boon

et al. 2023

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

show abstract

Educational group visits for the management of chronic health conditions: A systematic review

Cited by 45 publications

References 92 publications

A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression

A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression

What is the evidence for the effectiveness, appropriateness and feasibility of group clinics for patients with chronic conditions? A systematic review

Social network interventions to support cardiac rehabilitation and secondary prevention in the management of people with heart disease

Contact Info

Product

Resources

About