Trial reportBMJ open2015
Lessons learnt from a cluster-randomised trial evaluating the effectiveness of Self-Management Support (SMS) delivered by practice nurses in routine diabetes care.
Trial report in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 5 of them syntheses that pooled 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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 5 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- Evidence for the Use of Patient-Reported Outcome Measures in the Treatment of Patients With Noncommunicable Diseases: Systematic Review.JMIR medical informatics · 2025Pooled it
- Quality improvement strategies for diabetes care: Effects on outcomes for adults living with diabetes.The Cochrane database of systematic reviews · 2023Pooled it
- Routine provision of feedback from patient-reported outcome measurements to healthcare providers and patients in clinical practice.The Cochrane database of systematic reviews · 2021Pooled it
- Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice.PloS one · 2019Pooled it
- Psychological interventions for diabetes-related distress in adults with type 2 diabetes mellitus.The Cochrane database of systematic reviews · 2017Pooled it
- Transferability of nurse-led interventions for cardiovascular health across diverse nursing roles in primary and community settings: Practice implications and solutions from a scoping review.American journal of preventive cardiology · 2026Review
- 2026 EASD evidence-based clinical practice guideline for assessing and managing diabetes distress among adults with type 1 diabetes or type 2 diabetes.Diabetologia · 2026Article
- Interventions to reduce diabetes-related distress among adults with type 1 or type 2 diabetes: a systematic review and meta-analysis of randomised controlled trials.Diabetologia · 2026Article
- Enhancing Type 2 Diabetes Management Involving Healthcare Professionals in Primary Care.Healthcare (Basel, Switzerland) · 2026Review
- Rehabilitation in primary care for an ageing population: a secondary analysis from a scoping review of rehabilitation delivery models.BMC health services research · 2024Article
- Behavior change interventions in patients with type 2 diabetes: a systematic review of the effects on self-management and A1c.Journal of diabetes and metabolic disorders · 2021Review
- Article
- Peer Support to Enhance Social and Emotional Self-Management Following Acquired Brain Injury Rehabilitation: Design of a Pre-post Study With Process Evaluation.Frontiers in neurology · 2021Article
- Importance of congruence between communicating and executing implementation programmes: a qualitative study of focus group interviews.Implementation science communications · 2020Article
- Impact of a Boot Camp Translation Intervention on Self-Management Support in Primary Care: A Report From the INSTTEPP Trial and Meta-LARC Consortium.Journal of patient-centered research and reviews · 2018Article
- Mechanism of engaging self-management behavior in rural heart failure patients.Applied nursing research : ANR · 2016Article
- The Role of Nurses in Rehabilitation in Primary Health Care for Ageing Populations: A Secondary Analysis from a Scoping Review.SAGE open nursingArticle
- The Impact of Self-management Knowledge and Support on the Relationships Among Self-efficacy, Patient Activation, and Self-management in Rural Patients With Heart Failure.The Journal of cardiovascular nursingArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the effectiveness of biopsychosocial Self-Management Support (SMS) delivered by practice nurses in routine diabetes care.
designA pragmatic cluster-randomised controlled trial within a hybrid effectiveness-implementation study design. Practice nurses were cluster-randomised.
settingA regional care group in the Netherlands consisting of 77 family practices. The study involved practice nurses (n=40) providing care to approximately 4000 patients with diabetes.
participantsPatients with type 2 diabetes (n=264) selected by a self-administered questionnaire aimed at measuring emotional distress and diabetes-related reduced daily functioning.
interventionPractice nurses in the intervention arm (n=19) were trained to integrate SMS into their routine consultations. SMS included detection of patients with emotional distress and reduced daily functioning, and supporting them when needed through problem solving and reattribution techniques. Practice nurses in the control arm (n=21) provided usual care.
main outcome measuresThe primary outcome measure was a dichotomised score on a Visual Analogue Scale that measured the perceived effect of diabetes on daily functioning. Secondary measures included patients' diabetes-related distress, quality of life, autonomy and participation, self-efficacy, self-management and glycaemic control. Outcomes were measured at baseline and at 4-month and 12-month follow-ups.
resultsOnly 16 of the 117 patients in the intervention arm (14%) who were found eligible by the posted research-driven screening questionnaire were detected by their practice nurses. Extra consultations for the self-management support were delivered to only 11 study participants. In the control arm, 147 patients received usual care. Multilevel analyses showed no significant differences in outcomes between the intervention and control arms.
conclusionsSMS in its present form was not effective. The research-driven screening to select trial participants appeared to be inconsistent with nurse-led detection in routine practice. Adequate follow-up moments need to be built in to overcome barriers resulting from tension between the implementation and effectiveness parts of hybrid studies. TRIAL REGISTRATION NUMBER: Current Controlled Trials NTR2764.
Indexed as
Identifiers
What OpenQuestion holds
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.