Evidence map›Paper›PMID 31018971›Full record

ArticleCMAJ open

Clinical care gaps and solutions in diabetes and advanced chronic kidney disease: a patient-oriented qualitative research study.

Kristin K Clemens, Leah Getchell, Tracy Robinson, Bridget L Ryan, Jim O'Donnell, Sonja M Reichert

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
1.3field-weighted citation impact, top 20% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 13 citations in OpenAlex.

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  7. Perspectives on primary care management of obstructive sleep apnea: a qualitative study of patients and health care providers.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2021
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  9. How point-of-care HbADiabetic medicine : a journal of the British Diabetic Association · 2020
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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

6 authors at 1 institution in 1 country.

Kristin K ClemensDivision of Endocrinology and Metabolism, Department of Medicine (Clemens), Department of Epidemiology and Biostatistics (Clemens, Ryan) and Centre for Studies in Family Medicine (Ryan, Reichert), Western University; St. Joseph's Health Care London (Clemens), London, Ont.; ICES (Clemens, Getchell), London, Ont.; Children's Hospital (Robinson), London Health Sciences Centre; patient partner (O'Donnell), St. Joseph's Health Care London, London, Ont. kristin.clemens@sjhc.london.on.ca.
Leah GetchellDivision of Endocrinology and Metabolism, Department of Medicine (Clemens), Department of Epidemiology and Biostatistics (Clemens, Ryan) and Centre for Studies in Family Medicine (Ryan, Reichert), Western University; St. Joseph's Health Care London (Clemens), London, Ont.; ICES (Clemens, Getchell), London, Ont.; Children's Hospital (Robinson), London Health Sciences Centre; patient partner (O'Donnell), St. Joseph's Health Care London, London, Ont.
Tracy RobinsonDivision of Endocrinology and Metabolism, Department of Medicine (Clemens), Department of Epidemiology and Biostatistics (Clemens, Ryan) and Centre for Studies in Family Medicine (Ryan, Reichert), Western University; St. Joseph's Health Care London (Clemens), London, Ont.; ICES (Clemens, Getchell), London, Ont.; Children's Hospital (Robinson), London Health Sciences Centre; patient partner (O'Donnell), St. Joseph's Health Care London, London, Ont.
Bridget L RyanDivision of Endocrinology and Metabolism, Department of Medicine (Clemens), Department of Epidemiology and Biostatistics (Clemens, Ryan) and Centre for Studies in Family Medicine (Ryan, Reichert), Western University; St. Joseph's Health Care London (Clemens), London, Ont.; ICES (Clemens, Getchell), London, Ont.; Children's Hospital (Robinson), London Health Sciences Centre; patient partner (O'Donnell), St. Joseph's Health Care London, London, Ont.
Jim O'DonnellDivision of Endocrinology and Metabolism, Department of Medicine (Clemens), Department of Epidemiology and Biostatistics (Clemens, Ryan) and Centre for Studies in Family Medicine (Ryan, Reichert), Western University; St. Joseph's Health Care London (Clemens), London, Ont.; ICES (Clemens, Getchell), London, Ont.; Children's Hospital (Robinson), London Health Sciences Centre; patient partner (O'Donnell), St. Joseph's Health Care London, London, Ont.
Sonja M ReichertDivision of Endocrinology and Metabolism, Department of Medicine (Clemens), Department of Epidemiology and Biostatistics (Clemens, Ryan) and Centre for Studies in Family Medicine (Ryan, Reichert), Western University; St. Joseph's Health Care London (Clemens), London, Ont.; ICES (Clemens, Getchell), London, Ont.; Children's Hospital (Robinson), London Health Sciences Centre; patient partner (O'Donnell), St. Joseph's Health Care London, London, Ont.
London Health Sciences Centre · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with diabetes and advanced chronic kidney disease face a high health care burden. As part of a patient-oriented research initiative to identify ways to better support patients' diabetes care, we explored their health care experience and solutions for patient-centred diabetes care.

methodsWe engaged 2 patients with advanced kidney disease and diabetes to join our multidisciplinary team as full research partners. They were involved in our design and conduct of the study, the analysis of the results and knowledge translation. We conducted qualitative interviews (1:1 semistructured interviews and focus groups) with patients with a history of both diabetes (type 1 or 2) and advanced kidney disease including those using dialysis. We identified overarching themes using individual and team analysis and conducted interviews until data saturation was reached.

resultsTwelve participants were interviewed between October 2017 and February 2018. Six people were interviewed in 2 separate focus groups (consisting of 4 and 2 participants) and 6 participated in 1:1 interviews with our team. Participants described being burdened by medical appointments, strict conflicting diets, costly diabetes therapies and fragmented, siloed health care. They indicated that self-management support, education and coordinated diabetes care might better support their diabetes care.

interpretationPatients with complex medical comorbidities face many challenges traversing a health care system organized around single diseases. Researchers and policy-makers should study and develop patient-centred diabetes care strategies to better support these high-risk patients.

Identifiers

PMID31018971
PMCPMC6498446
OpenAlexW2942188537

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.