Knowledge of diabetes, problem solving ability, Trento Reduction quality of life, health 3 mthly/~2 Usual GP 112 patients 5 yrs Diabetes clinic (2004)[33] of HbA1c problem identification, hrs care with diabetes progression of retinopathy 120 Adult Adult primary Lipid profiles, Trust in patients with care centre, Clancy Reduction Usual GP Physician scale, patient Mthly/ 2hrs 6 mths type 2 medical (2002)[30] of HbA1c care care assessment tool diabetes, university of HbA1c > 8.5% South Carolina Specialty and Usual GP emergency room visits, 707 patients Health Wagner Reduction 3 mthly to 6 care plus bed disability days, 2 yrs with diabetes, management (2001)[44] of HbA1c mthly/~ 2 hrs group Short-Form 36 general age > 30 organisation education health Reduction in hospital admission rates, ~142-156 Health Sadur Reduction treating Usual GP patients with Mthly/2 hrs 6 mths management (1999)[32] of HbA1c hypoglycaemia, care diabetes with organisation managing glucose HbA1c > 8.5% when ill Adverse events from T2DM that could be assessed are [21]: Hypoglycaemic events (all, serious, nocturnal) Cardiovascular events Amputations; Microvascular events (retinopathy, neuropathy, nephropathy rates); and Mortality rates. However, these events may be too rare, or may happen over too long a time horizon, to be properly captured in any prospective RCT. Other indicators relating to patient quality of life which could be considered would be: Knowledge of diabetes/ health literacy Quality of life/anxiety score ‘Trust in physician’ score Safety There is no safety concerns associated with the intervention. There may be a concern with confidentiality, as some people may not feel comfortable discussing their health in front of other patients. For this reason, shared medical appointments would be voluntary, and standard GP visits would always be available to those who want them. An additional
Trento (2004)[33] Reduction of HbA1c Knowledge of diabetes, problem solving ability, quality of life, health problem identification, progression of retinopathy 3 mthly/~2 hrs Usual GP care 5 yrs 112 patients with diabetes Diabetes clinic Clancy (2002)[30] Reduction of HbA1c Lipid profiles, Trust in Physician scale, patient care assessment tool Mthly/ 2hrs Usual GP care 6 mths 120 Adult patients with type 2 diabetes, HbA1c > 8.5% Adult primary care centre, medical university of South Carolina Wagner (2001)[44] Reduction of HbA1c Specialty and emergency room visits, bed disability days, Short-Form 36 general health 3 mthly to 6 mthly/~ 2 hrs Usual GP care plus group education 2 yrs 707 patients with diabetes, age > 30 Health management organisation Sadur (1999)[32] Reduction of HbA1c Reduction in hospital admission rates, treating hypoglycaemia, managing glucose when ill Mthly/2 hrs Usual GP care 6 mths ~142-156 patients with diabetes with HbA1c > 8.5% Health management organisation Adverse events from T2DM that could be assessed are [21]: Hypoglycaemic events (all, serious, nocturnal) Cardiovascular events Amputations; Microvascular events (retinopathy, neuropathy, nephropathy rates); and Mortality rates. However, these events may be too rare, or may happen over too long a time horizon, to be properly captured in any prospective RCT. Other indicators relating to patient quality of life which could be considered would be: Knowledge of diabetes/ health literacy Quality of life/anxiety score ‘Trust in physician’ score Safety There is no safety concerns associated with the intervention. There may be a concern with confidentiality, as some people may not feel comfortable discussing their health in front of other patients. For this reason, shared medical appointments would be voluntary, and standard GP visits would always be available to those who want them. An additional