Evidence map›Paper›PMID 24766179›Full record

Trial reportDiabetic medicine : a journal of the British Diabetic Association2014

Effectiveness of a group diabetes education programme in under-served communities in South Africa: a pragmatic cluster randomized controlled trial.

R J Mash, H Rhode, M Zwarenstein, S Rollnick, C Lombard, K Steyn, N Levitt

2 registry-linked trialsOpen access · bronzeAbstract readMulticenter StudyRandomized Controlled TrialPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Diabetic medicine : a journal of the British Diabetic Association, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 74 papers, 24 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
74citing papers in PubMed, 24 pooled it
3.2field-weighted citation impact, top 8% of its field
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.

NCT03185689 nacompletednot on this mapstarted 2016, after this paper: background citation

Effect of Diabetic Self-management Education (DSME) on Clinical, Psychosocial, and Behavioral Outcomes Among People With Type 2 Diabetes Attending Jimma University Medical Center (JUMC)

TypeinterventionalSponsorJimma UniversityRan2016 to 2017Enrolled240ConditionsDiabetes Mellitus, Type 2ArmsEffectiveness of an intensified DSME in T2D adult patients
NCT03376607 naunknown statusnot on this mapstarted 2019, after this paper: background citation

Community- and mHealth-Based Integrated Management of Diabetes in Primary Healthcare in Rwanda: The D²Rwanda Study

TypeinterventionalSponsorUniversity of AarhusRan2019 to 2021Enrolled209ConditionsDiabetes Mellitus, Telemedicine, Community Health WorkersArmsHBCP programme, mobile health application
3 · Its place in the literature

Who cites it

74 citing papers in PubMed, 24 syntheses or guidelines pooled it, 134 citations in OpenAlex.

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14 more citing papers are in PubMed but not listed here.

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

7 authors at 5 institutions in 3 countries.

R J MashDivision of Family Medicine and Primary Care, Stellenbosch University, Cape Town, South Africa.
H Rhode
M Zwarenstein
S Rollnick
C Lombard
K Steyn
N Levitt
Stellenbosch University · ZAUniversity of Cape Town · ZACardiff University · GBSouth African Medical Research Council · ZAUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo evaluate the effectiveness of group education, led by health promoters using a guiding style, for people with type 2 diabetes in public sector community health centres in Cape Town.

methodsThis was a pragmatic clustered randomized controlled trial with 17 randomly selected intervention and 17 control sites. A total of 860 patients with type 2 diabetes, regardless of therapy used, were recruited from the control sites and 710 were recruited from the intervention sites. The control sites offered usual care, while the intervention sites offered a total of four monthly sessions of group diabetes education led by a health promoter. Participants were measured at baseline and 12 months later. Primary outcomes were diabetes self-care activities, 5% weight loss and a 1% reduction in HbA(1c) levels. Secondary outcomes were self-efficacy, locus of control, mean blood pressure, mean weight loss, mean waist circumference, mean HbA1c and mean total cholesterol levels and quality of life.

resultsA total of 422 (59.4%) participants in the intervention group did not attend any education sessions. No significant improvement was found in any of the primary or secondary outcomes, apart from a significant reduction in mean systolic (-4.65 mmHg, 95% CI 9.18 to -0.12; P = 0.04) and diastolic blood pressure (-3.30 mmHg, 95% CI -5.35 to -1.26; P = 0.002). Process evaluation suggested that there were problems with finding suitable space for group education in these under-resourced settings, with patient attendance and with full adoption of a guiding style by the health promoters.

conclusionThe reported effectiveness of group diabetes education offered by more highly trained professionals, in well-resourced settings, was not replicated in the present study, although the reduction in participants' mean blood pressure is likely to be of clinical significance.

Indexed as

Group ProcessesPatient Education as TopicSelf CareAdultAgedCluster AnalysisCombined Modality TherapyCommunity Health CentersDiabetes Mellitus, Type 2FemaleFollow-Up StudiesHumansHyperglycemiaHypertensionMaleMedically Underserved Area

Identifiers

PMID24766179
PMCPMC4232864
OpenAlexW2045086428

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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 OpenQuestion graph.