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Shared Medical Appointments and Mindfulness for Type 2 Diabetes-A Mixed-Methods Feasibility Study.

Frontiers in endocrinology
January 1, 2020
Carolyn Ee et al. (18 authors)
Journal ArticleRandomized Controlled TrialResearch Support, Non-U.S. Gov'tHuman StudyClinical
Study Details

Study Goal

The researchers aimed to assess the feasibility and acceptability of shared medical appointments (SMAs) with mindfulness for managing Type 2 diabetes (T2DM) in primary care.

Results Summary

Participants reported positive experiences, including improved psychosocial wellbeing and better glycemic control. Four out of six participants found the mindfulness component helpful, while two did not.

Population

Adults aged 21+ with T2DM (HbA1c > 6.5% or fasting glucose >7.00 mmol/L) in Western Sydney, Australia.

Effective Dosage

Six 2-hour programmed SMAs (pSMAs) held fortnightly, including a mindfulness component.

Duration

12 weeks (intervention period).

Interactions

None mentioned

Extracted Claims (6)
InterventionDirectionEndpointPopulationDosageImpactClaim #
programmed shared medical appointments (pSMAs) with mindfulness
decrease
weight loss
people with type 2 diabetes (T2DM)
-
led to beneficial effects including
#1
programmed shared medical appointments (pSMAs) with mindfulness
increase
glycemic control
people with type 2 diabetes (T2DM)
-
led to beneficial effects including
#2
mindfulness component
neutral
-
four pSMA participants
-
found helpful
#3
mindfulness component
neutral
-
two pSMA participants
-
did not find helpful
#4
programmed shared medical appointments (pSMAs) with mindfulness
increase
psychosocial wellbeing
seven participants who contributed to qualitative evaluation
-
reported improved
#5
programmed shared medical appointments (pSMAs) with mindfulness
decrease
total cholesterol levels
people with type 2 diabetes (T2DM)
3.86 mmol/L in intervention group vs. 4.15 mmol/L in the control group
significant difference in
#6
Abstract

INTRODUCTION: Type 2 diabetes (T2DM) is a major health concern with significant personal and healthcare system costs. There is growing interest in using shared medical appointments (SMAs) for management of T2DM. We hypothesize that adding mindfulness to SMAs may be beneficial. This study aimed to assess the feasibility and acceptability of SMAs with mindfulness for T2DM within primary care in Australia. MATERIALS AND METHODS: We conducted a single-blind randomized controlled feasibility study of SMAs within primary care for people with T2DM living in Western Sydney, Australia. People with T2DM, age 21 years and over, with HbA1c > 6.5% or fasting glucose >7.00 mmol/L within the past 3 months were eligible to enroll. The intervention group attended six 2-h programmed SMAs (pSMAs) which were held fortnightly. pSMAs included a structured education program and mindfulness component. The control group received usual care from their healthcare providers. We collected quantitative and qualitative data on acceptability as well as glycemic control (glycated hemoglobin and continuous glucose monitoring), lipids, anthropometric measures, blood pressure, self-reported psychological outcomes, quality of life, diet, and physical activity using an ActiGraph accelerometer. RESULTS: Over a 2-month period, we enrolled 18 participants (10 females, 8 males) with a mean age of 58 years (standard deviation 9.8). We had 94.4% retention. All participants in the intervention group completed at least four pSMAs. Participants reported that attending pSMAs had been a positive experience that allowed them to accept their diagnosis and empowered them to make changes, which led to beneficial effects including weight loss and better glycemic control. Four pSMA participants found the mindfulness component helpful while two did not. All of the seven participants who contributed to qualitative evaluation reported improved psychosocial wellbeing and found the group setting beneficial. There was a significant difference in total cholesterol levels at 12 weeks between groups (3.86 mmol/L in intervention group vs. 4.15 mmol/L in the control group; CONCLUSION: pSMAs are feasible and acceptable to people with T2DM and may result in clinical improvement. A follow-up fully-powered randomized controlled trial is warranted. CLINICAL TRIAL REGISTRATION: Australia and New Zealand Clinical Trial Registry, identifier ACTRN12619000892112.

Medical Subject Headings (MeSH)
AdultAgedBlood GlucoseDiabetes Mellitus, Type 2ExerciseFeasibility StudiesFemaleHumansMaleMiddle AgedMindfulnessProspective StudiesRisk Reduction BehaviorShared Medical AppointmentsSingle-Blind MethodWeight Loss
Study Links
Quality Scores
SafetyNot Assessed
Efficacy75/10
Quality80/10
Citation Metrics
Total Citations6
Citations/Year1.2
Relative Citation Ratio0.60
NIH Percentile32.7%
Research Impact Scores
APT Score0.50
Weight Score2.23
Normalized Score0.66
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