Problem-solving therapy for adults with diabetic retinopathy and diabetes-specific distress: a pilot randomized controlled trial

Rees, Gwyneth; O’Hare, Fleur; Saeed, Marian; Sudholz, Bronwyn; Sturrock, Bonnie A.; Xie, Jing; Speight, Jane; Lamoureux, Ecosse L.

doi:10.1136/bmjdrc-2016-000307

Cited by 24 publications

(63 citation statements)

References 21 publications

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“…In addition, the dropout rate of the multidisciplinary collaborative care arm remained comparable to the dropout rate observed in the intervention arms of similar studies conducted in other countries (8.1%-59.5%). [33][34][35] Furthermore, the overall dropout rate of our study was consistent with other randomized controlled trials (19%-29%). 36 outpatient medical costs from an institution's perspective.…”

Section: Discussionsupporting

confidence: 90%

“…This study, however, was still sufficiently powered to detect the differences between the two arms. In addition, the dropout rate of the multidisciplinary collaborative care arm remained comparable to the dropout rate observed in the intervention arms of similar studies conducted in other countries (8.1%‐59.5%) . Furthermore, the overall dropout rate of our study was consistent with other randomized controlled trials (19%‐29%) .…”

Section: Discussionsupporting

confidence: 88%

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Impact of pharmacist-involved collaborative care on the clinical, humanistic and cost outcomes of high-risk patients with type 2 diabetes (IMPACT): a randomized controlled trial

et al. 2017

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SummaryWhat is known and objective: With the increasing prevalence of diabetes, the physician-centred model is challenged to deliver holistic care in Asia. Diabetes may be managed effectively within a multidisciplinary collaborative care model; however, evidence on its effectiveness in Asian patients is lacking. Therefore, the primary objective was to evaluate the clinical outcomes of multidisciplinary collaborative care vs physician-centred care in diabetes. The secondary objectives were to evaluate humanistic and economic outcomes among the two types of care.Methods: This 6-month prospective, open-label, parallel-arm, randomized, controlled study was conducted at four outpatient healthcare institutions. High-risk patients aged ≥21 years with uncontrolled type 2 diabetes, polypharmacy and comorbidities were included. Patients with type 1 diabetes or those who were unable to communicate independently were excluded. The control arm received usual care with referrals to nurses and dietitians as needed. The intervention arm (multidisciplinary collaborative care) was followed up with pharmacists regularly, in addition to receiving the usual care. The primary outcomes included HbA1c, systolic blood pressure, low-density lipoprotein and triglycerides. The secondary outcomes included scores from the Problem Areas in Diabetes (PAID) and the Diabetes Treatment Satisfaction Questionnaires (DTSQ), and diabetes-related health service utilization rates and costs.Results and discussion: Of 411 eligible patients, 214 and 197 patients were randomized into the intervention and control arms, respectively. At 6 months, 141 patients in the intervention arm (65.9%) and 189 patients in the control arm (95.9%) completed the study. Mean HbA1c reduced from 8.6%±1.5% at baseline to 8.1%±1.3% at 6 months in the intervention arm (P=.04), with up to mean HbA1c improvement of 0.8% in patients with greater levels of uncontrolled glycemia. Whereas the mean HbA1c in the control arm remained unchanged (8.5%±1.4%) throughout the 6-month period. Improvements in PAID and DTSQ scores, reduction in physician workload and an average cost savings of US$91.01 per patient were observed in the intervention arm over 6 months.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 88%

Impact of pharmacist-involved collaborative care on the clinical, humanistic and cost outcomes of high-risk patients with type 2 diabetes (IMPACT): a randomized controlled trial

et al. 2017

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“…They assessed two primary outcomes: depressive symptoms and diabetes-distress, and included only people with elevated depressive symptoms and/or elevated diabetes-distress. Diabetes-distress declined more in the intervention group than in (9) Only Rees et al [34] investigated the effect of a psychological intervention specifically aimed at reducing diabetesdistress, compared with care as usual. After 3 months, the PAID score in the I-MBCT group significantly decreased more than that in the control group: 41.6 (15.…”

Section: Study Resultsmentioning

confidence: 99%

“…Only Rees et al [34] investigated the effect of a psychological intervention specifically aimed at reducing diabetesdistress, compared with care as usual. This Australian study included people with Type 2 diabetes with retinopathy and at least moderate diabetes-distress (DDS ≥ 2).…”

Section: Study Resultsmentioning

confidence: 99%

“…A second post-hoc analysis was carried out with diabetestailored interventions [33,34], which seemed to significantly reduce HbA 1c levels (k = 2), Cohen's d = 0.57 (CI 0.18 to 0.95), Z = 2.88, P = 0.004, I² = 0% (CI 0% to 65.61%), v² = 0.37, P = 0.54. Despite the small study numbers, the effect on HbA 1c seemed to differ between intervention types: a significant decrease in HbA 1c was obtained by diabetestailored interventions, in contrast to general mindfulnessbased interventions.…”

Section: Other Outcomesmentioning

confidence: 99%

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Systematic review and meta‐analysis of psychological interventions in people with diabetes and elevated diabetes‐distress

Schmidt

Loon

Vergouwen³

et al. 2018

Diabet. Med.

118

105

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Quality improvement strategies for diabetes care: Effects on outcomes for adults living with diabetes

Yogasingam

Konnyu

Lépine

et al. 2023

Cochrane Database of Systematic Reviews

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Background There is a large body of evidence evaluating quality improvement (QI) programmes to improve care for adults living with diabetes. These programmes are often comprised of multiple QI strategies, which may be implemented in various combinations. Decision‐makers planning to implement or evaluate a new QI programme, or both, need reliable evidence on the relative effectiveness of different QI strategies (individually and in combination) for different patient populations. Objectives To update existing systematic reviews of diabetes QI programmes and apply novel meta‐analytical techniques to estimate the effectiveness of QI strategies (individually and in combination) on diabetes quality of care. Search methods We searched databases (CENTRAL, MEDLINE, Embase and CINAHL) and trials registers (ClinicalTrials.gov and WHO ICTRP) to 4 June 2019. We conducted a top‐up search to 23 September 2021; we screened these search results and 42 studies meeting our eligibility criteria are available in the awaiting classification section. Selection criteria We included randomised trials that assessed a QI programme to improve care in outpatient settings for people living with diabetes. QI programmes needed to evaluate at least one system‐ or provider‐targeted QI strategy alone or in combination with a patient‐targeted strategy. ‐ System‐targeted: case management (CM); team changes (TC); electronic patient registry (EPR); facilitated relay of clinical information (FR); continuous quality improvement (CQI). ‐ Provider‐targeted: audit and feedback (AF); clinician education (CE); clinician reminders (CR); financial incentives (FI). ‐ Patient‐targeted: patient education (PE); promotion of self‐management (PSM); patient reminders (PR). Patient‐targeted QI strategies needed to occur with a minimum of one provider or system‐targeted strategy. Data collection and analysis We dual‐screened search results and abstracted data on study design, study population and QI strategies. We assessed the impact of the programmes on 13 measures of diabetes care, including: glycaemic control (e.g. mean glycated haemoglobin (HbA1c)); cardiovascular risk factor management (e.g. mean systolic blood pressure (SBP), low‐density lipoprotein cholesterol (LDL‐C), proportion of people living with diabetes that quit smoking or receiving cardiovascular medications); and screening/prevention of microvascular complications (e.g. proportion of patients receiving retinopathy or foot screening); and harms (e.g. proportion of patients experiencing adverse hypoglycaemia or hyperglycaemia). We modelled the association of each QI strategy with outcomes using a series of hierarchical multivariable meta‐regression models in a Bayesian framework. The previous version of this review identified that different strategies were more or less effective depending on baseline levels of outco...

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Problem-solving therapy for adults with diabetic retinopathy and diabetes-specific distress: a pilot randomized controlled trial

Cited by 24 publications

References 21 publications

Impact of pharmacist-involved collaborative care on the clinical, humanistic and cost outcomes of high-risk patients with type 2 diabetes (IMPACT): a randomized controlled trial

Impact of pharmacist-involved collaborative care on the clinical, humanistic and cost outcomes of high-risk patients with type 2 diabetes (IMPACT): a randomized controlled trial

Systematic review and meta‐analysis of psychological interventions in people with diabetes and elevated diabetes‐distress

Quality improvement strategies for diabetes care: Effects on outcomes for adults living with diabetes

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