The English national health service diabetes prevention programme (NHS DPP): A scoping review of existing evidence

Whelan, Maxine E; Bell, Lauren

doi:10.1111/dme.14855

Cited by 15 publications

(5 citation statements)

References 29 publications

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“…However, in contrast to the stable gaps across ethnicity and deprivation observed in the same US study [ 43 ], we observed a narrowing then widening but persistent gap across ethnicity and socioeconomic status. These divergent findings may be related to differences between the two countries in social and healthcare systems and their reforms in the last two decades [ 44 , 45 ] and in the measurement of socioeconomic status and classification of ethnicities. Of note, clinical coding of ethnicities has improved over time in the CPRD [ 46 ], which may also have influenced our results.…”

Section: Discussionmentioning

confidence: 99%

Inequalities in cancer mortality trends in people with type 2 diabetes: 20 year population-based study in England

Ling,

Zaccardi,

Issa

et al. 2023

Diabetologia

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Aims/hypothesis The aim of this study was to describe the long-term trends in cancer mortality rates in people with type 2 diabetes based on subgroups defined by sociodemographic characteristics and risk factors. Methods We defined a cohort of individuals aged ≥35 years who had newly diagnosed type 2 diabetes in the Clinical Practice Research Datalink between 1 January 1998 and 30 November 2018. We assessed trends in all-cause, all-cancer and cancer-specific mortality rates by age, gender, ethnicity, socioeconomic status, obesity and smoking status. We used Poisson regression to calculate age- and calendar year-specific mortality rates and Joinpoint regression to assess trends for each outcome. We estimated standardised mortality ratios comparing mortality rates in people with type 2 diabetes with those in the general population. Results Among 137,804 individuals, during a median follow-up of 8.4 years, all-cause mortality rates decreased at all ages between 1998 and 2018; cancer mortality rates also decreased for 55- and 65-year-olds but increased for 75- and 85-year-olds, with average annual percentage changes (AAPCs) of –1.4% (95% CI –1.5, –1.3), –0.2% (–0.3, –0.1), 1.2% (0.8, 1.6) and 1.6% (1.5, 1.7), respectively. Higher AAPCs were observed in women than men (1.5% vs 0.5%), in the least deprived than the most deprived (1.5% vs 1.0%) and in people with morbid obesity than those with normal body weight (5.8% vs 0.7%), although all these stratified subgroups showed upward trends in cancer mortality rates. Increasing cancer mortality rates were also observed in people of White ethnicity and former/current smokers, but downward trends were observed in other ethnic groups and non-smokers. These results have led to persistent inequalities by gender and deprivation but widening disparities by smoking status. Constant upward trends in mortality rates were also observed for pancreatic, liver and lung cancer at all ages, colorectal cancer at most ages, breast cancer at younger ages, and prostate and endometrial cancer at older ages. Compared with the general population, people with type 2 diabetes had a more than 1.5-fold increased risk of colorectal, pancreatic, liver and endometrial cancer mortality during the whole study period. Conclusions/interpretation In contrast to the declines in all-cause mortality rates at all ages, the cancer burden has increased in older people with type 2 diabetes, especially for colorectal, pancreatic, liver and endometrial cancer. Tailored cancer prevention and early detection strategies are needed to address persistent inequalities in the older population, the most deprived and smokers. Graphical abstract

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Section: Discussionmentioning

confidence: 99%

Inequalities in cancer mortality trends in people with type 2 diabetes: 20 year population-based study in England

Ling,

Zaccardi,

Issa

et al. 2023

Diabetologia

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“…SUSAN E MANLEY, 1,2,3 ANDREAS KARWATH, 1,4,5,6 JOHN A WILLIAMS, 1,5,6,7 JONATHAN WEBBER, 1,8 RAJEEV P RAGHAVAN, 9 BALDEV M SINGH, 9,10 CRAIG WEBSTER, 11 RACHEL A ROUND, 1,11 IRENE M STRATTON, 1,12,13 GEORGIOS V GKOUTOS, 1,4,5,6,14,15,16 * GRAHAM A ROBERTS 1, 17,18,19 In the printed issue of the article above, the affiliation for author Sandip Ghosh was missing. The correction has been made to the author box -see opposite -and the online version has been updated and can be viewed at https://bjd-abcd.com/index.php/bjd/article/view/971 Hospitals Birmingham NHS Foundation Trust, Birmingham, UK 9 Diabetes Endocrine Services, Diabetes Endocrine Centre, Location C28, New Cross Hospital, Royal Wolverhampton Trust, Wolverhampton, UK 10 Faculty of Science and Engineering, University of Wolverhampton, Wolverhampton, UK 11 Clinical Laboratory Services, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK 12 University of Oxford, Oxford, UK 13 University of Southampton, Southampton, UK 14 NIHR Experimental Cancer Medicine Centre, Birmingham, UK 15…”

Section: Conflict Of Interest Nonementioning

confidence: 99%

“…However, this program was designed for the general population, who may not face the unique barriers present for women with young families, such as other family commitments, lack of childcare and other responsibilities. 9,10 This could in part explain why people who do engage with these lifestyle programs tend to be over the age of 65 years, 11 and why GDM patients' participation in prevention interventions is variable. 12 Overcoming engagement barriers to lifestyle changes in this population is important for lasting behaviour change and subsequent T2DM risk management.…”

Section: Introductionmentioning

confidence: 99%

systematic review and thematic synthesis of the barriers and facilitators to physical activity for women after gestational diabetes: a socio-ecological approach

et al. 2023

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Physical activity can reduce risk of type 2 diabetes (T2DM) after gestational diabetes. Understanding barriers and facilitators to physical activity, using a socio-ecological approach, could better direct multi-level interventions. The present review aimed to synthesise barriers and facilitators to physical activity, and to develop an understanding of where, across the socio-ecological model, these factors exist and/or are interrelated. Eligible studies included women with a history of gestational diabetes and a discussion around physical activity. A systematic search of MEDLINE, the Cochrane Library, Web of Science, CINAHL Complete and Scopus was conducted in October 2022. Barriers and facilitators to physical activity were thematically analysed and themes organised according to the socio-ecological model. Twenty-nine studies were included. Barriers pertained to leisure time physical activity, while other types of activity including housework and transport were overlooked, despite being routine. Partner and family support were vital for engagement with activity, whether emotional support or provision of childcare. Most barriers and facilitators at the social and organisational levels were interrelated with those at the individual level. These ﬁndings suggest that multi-level physical activity interventions after gestational diabetes could be most effective.

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“…The national DPP in England reports uptake by the first 100,000 referred to the programme was 56%, with only 19% completing it 18 . In a scoping review of existing evidence of the National Health Service DPP in England, the lack of evidence on how to improve initial engagement with the programme was highlighted and efforts to improve recruitment of those of working age, those from deprived and ethnic minority backgrounds was recommended 19 .…”

Section: Introductionmentioning

confidence: 99%

Healthcare workers’ perspectives on barriers and facilitators to referral and recruitment to diabetes prevention programmes: a systematic review protocol

Haseldine,

O'Donoghue,

Kearney

et al. 2024

HRB Open Res

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Background Diabetes is a growing global health problem. International guidelines recommend identification, screening, and referral to behavioural programmes for those at high risk of developing type 2 diabetes. Diabetes prevention programmes (DPPs) can prevent type 2 diabetes in those at high risk, however many eligible participants are not referred to these programmes. Healthcare workers (HCWs) are pivotal to the referral and recruitment processes. This study aims to identify, appraise and synthesise the evidence on barriers and facilitators to referral and recruitment to DPPs from the perspective of HCWs. Methods A “best fit” framework synthesis method will synthesise qualitative, quantitative, and mixed methods evidence on factors that affect HCWs referral and recruitment to DPPs, with the Theoretical Domains Framework (TDF) as the a priori framework. MEDLINE, EMBASE, CINAHL, PsychINFO, Web of Science and Scopus will be searched for primary studies published in English. Year of publication will be restricted to the last 26 years (1997–2023). Quality will be assessed using the Mixed Methods Appraisal Tool. A mix of deductive coding using the TDF and inductive coding of data that does not fit the TDF will be synthesised into themes representing the whole dataset. The relationships between the final set of themes will be explored to create a new model to understand HCWs’ perspectives on referral and recruitment to DPPs. Sensitivity analysis will be carried out on this conceptual model. Confidence in the synthesised findings will be assessed using the GRADE-CERQual approach. One author will screen, extract, appraise the literature while a second author will independently verify a 20% sample at each stage. Discussion Participation in DPPs is key for programme impact. HCWs typically identify those at risk and refer them to DPPs. Understanding HCWs’ perspectives on the barriers and facilitators to referral and recruitment will inform future implementation of DPPs.

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The English national health service diabetes prevention programme (NHS DPP): A scoping review of existing evidence

Cited by 15 publications

References 29 publications

Inequalities in cancer mortality trends in people with type 2 diabetes: 20 year population-based study in England

Inequalities in cancer mortality trends in people with type 2 diabetes: 20 year population-based study in England

systematic review and thematic synthesis of the barriers and facilitators to physical activity for women after gestational diabetes: a socio-ecological approach

Healthcare workers’ perspectives on barriers and facilitators to referral and recruitment to diabetes prevention programmes: a systematic review protocol

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