Shared Medical Appointments and Mindfulness for Type 2 Diabetes—A Mixed-Methods Feasibility Study
IntroductionType 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 asse...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-10-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fendo.2020.570777/full |
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| author | Carolyn Ee Carolyn Ee Barbora de Courten Nicole Avard Michael de Manincor Mahmoud A. Al-Dabbas Jie Hao Kate McBride Kate McBride Shamieka Dubois Rhiannon Lee White Catharine Fleming Catharine Fleming Garry Egger Angela Blair John Stevens Freya MacMillan Freya MacMillan Gary Deed Suzanne Grant Kate Templeman Dennis Chang |
| author_facet | Carolyn Ee Carolyn Ee Barbora de Courten Nicole Avard Michael de Manincor Mahmoud A. Al-Dabbas Jie Hao Kate McBride Kate McBride Shamieka Dubois Rhiannon Lee White Catharine Fleming Catharine Fleming Garry Egger Angela Blair John Stevens Freya MacMillan Freya MacMillan Gary Deed Suzanne Grant Kate Templeman Dennis Chang |
| author_sort | Carolyn Ee |
| collection | DOAJ |
| description | IntroductionType 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 MethodsWe 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.ResultsOver 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; p = 0.025) as well as pain intensity levels as measured by the PROMIS-29 (2.11 vs. 2.38; p = 0.034).ConclusionpSMAs 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 RegistrationAustralia and New Zealand Clinical Trial Registry, identifier ACTRN12619000892112. |
| first_indexed | 2024-12-19T06:21:18Z |
| format | Article |
| id | doaj.art-b03ebf6e03014be2996d14c9c8f8ff81 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-12-19T06:21:18Z |
| publishDate | 2020-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-b03ebf6e03014be2996d14c9c8f8ff812022-12-21T20:32:42ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922020-10-011110.3389/fendo.2020.570777570777Shared Medical Appointments and Mindfulness for Type 2 Diabetes—A Mixed-Methods Feasibility StudyCarolyn Ee0Carolyn Ee1Barbora de Courten2Nicole Avard3Michael de Manincor4Mahmoud A. Al-Dabbas5Jie Hao6Kate McBride7Kate McBride8Shamieka Dubois9Rhiannon Lee White10Catharine Fleming11Catharine Fleming12Garry Egger13Angela Blair14John Stevens15Freya MacMillan16Freya MacMillan17Gary Deed18Suzanne Grant19Kate Templeman20Dennis Chang21NICM Health Research Institute, Western Sydney University, Penrith, NSW, AustraliaTranslational Health Research Institute, Western Sydney University, Penrith, NSW, AustraliaDepartment of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC, AustraliaNext Practice Health, Erina, Sydney, NSW, AustraliaNICM Health Research Institute, Western Sydney University, Penrith, NSW, AustraliaNICM Health Research Institute, Western Sydney University, Penrith, NSW, AustraliaNICM Health Research Institute, Western Sydney University, Penrith, NSW, AustraliaTranslational Health Research Institute, Western Sydney University, Penrith, NSW, AustraliaSchool of Medicine, Western Sydney University, Penrith, NSW, AustraliaTranslational Health Research Institute, Western Sydney University, Penrith, NSW, AustraliaSchool of Health Sciences, Western Sydney University, Penrith, NSW, AustraliaTranslational Health Research Institute, Western Sydney University, Penrith, NSW, AustraliaSchool of Health Sciences, Western Sydney University, Penrith, NSW, AustraliaSchool of Health and Human Sciences, Southern Cross University, Lismore, NSW, AustraliaDiabetes NSW and ACT, Sydney, NSW, AustraliaSchool of Health and Human Sciences, Southern Cross University, Lismore, NSW, AustraliaTranslational Health Research Institute, Western Sydney University, Penrith, NSW, AustraliaSchool of Health Sciences, Western Sydney University, Penrith, NSW, AustraliaMediwell Clinic, Brisbane, QLD, AustraliaNICM Health Research Institute, Western Sydney University, Penrith, NSW, AustraliaNICM Health Research Institute, Western Sydney University, Penrith, NSW, AustraliaNICM Health Research Institute, Western Sydney University, Penrith, NSW, AustraliaIntroductionType 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 MethodsWe 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.ResultsOver 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; p = 0.025) as well as pain intensity levels as measured by the PROMIS-29 (2.11 vs. 2.38; p = 0.034).ConclusionpSMAs 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 RegistrationAustralia and New Zealand Clinical Trial Registry, identifier ACTRN12619000892112.https://www.frontiersin.org/article/10.3389/fendo.2020.570777/fulltype 2 diabetesprimary careshared medical appointmentsmindfulnessglycemic controlfeasibility study, pSMAs for type 2 diabetes |
| spellingShingle | Carolyn Ee Carolyn Ee Barbora de Courten Nicole Avard Michael de Manincor Mahmoud A. Al-Dabbas Jie Hao Kate McBride Kate McBride Shamieka Dubois Rhiannon Lee White Catharine Fleming Catharine Fleming Garry Egger Angela Blair John Stevens Freya MacMillan Freya MacMillan Gary Deed Suzanne Grant Kate Templeman Dennis Chang Shared Medical Appointments and Mindfulness for Type 2 Diabetes—A Mixed-Methods Feasibility Study Frontiers in Endocrinology type 2 diabetes primary care shared medical appointments mindfulness glycemic control feasibility study, pSMAs for type 2 diabetes |
| title | Shared Medical Appointments and Mindfulness for Type 2 Diabetes—A Mixed-Methods Feasibility Study |
| title_full | Shared Medical Appointments and Mindfulness for Type 2 Diabetes—A Mixed-Methods Feasibility Study |
| title_fullStr | Shared Medical Appointments and Mindfulness for Type 2 Diabetes—A Mixed-Methods Feasibility Study |
| title_full_unstemmed | Shared Medical Appointments and Mindfulness for Type 2 Diabetes—A Mixed-Methods Feasibility Study |
| title_short | Shared Medical Appointments and Mindfulness for Type 2 Diabetes—A Mixed-Methods Feasibility Study |
| title_sort | shared medical appointments and mindfulness for type 2 diabetes a mixed methods feasibility study |
| topic | type 2 diabetes primary care shared medical appointments mindfulness glycemic control feasibility study, pSMAs for type 2 diabetes |
| url | https://www.frontiersin.org/article/10.3389/fendo.2020.570777/full |
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