TY - JOUR
T1 - Educational group visits for the management of chronic health conditions
T2 - A systematic review
AU - Quiñones, Ana R.
AU - Richardson, Jeannette
AU - Freeman, Michele
AU - Fu, Rochelle
AU - O'Neil, Maya E.
AU - Motu'apuaka, Makalapua
AU - Kansagara, Devan
N1 - Funding Information:
Funders: The research reported here was supported by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service Evidence-based Synthesis Program (ESP) project #05-225. Dr. Quiñones is a Health Science Specialist at the Portland VA Medical Center. Dr. Quiñones is also supported by American Diabetes Association Grant 7-13-CD-08 . The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs nor the American Diabetes Association.
PY - 2014/4
Y1 - 2014/4
N2 - Objective: Review the effectiveness of group visits (appointments of multiple patients) on quality of life, function, self-efficacy, utilization, and biophysical outcomes in randomized controlled trials of patients with chronic conditions. Methods: We searched MEDLINE®, Cochrane, CINAHL, and PsycINFO to January 2013 for English-language trials of educational group visits led by non-prescribing facilitators (e.g., peer educators). Results: We report on 80 arthritis/falls (n= 22), asthma/COPD (n= 10), CHF/hypertension (n= 12), diabetes (n= 29), multiple conditions (n= 4), and pain (n= 4) studies. We found moderate evidence of improved short-term self-efficacy in patients with arthritis (10 studies) and diabetes (10 studies). We found no consistent evidence of improved quality of life; however a moderately strong body of evidence suggests peer-led community-based programs might improve quality of life and utilization in patients with multiple chronic conditions. Meta-analyses found short- (14 studies; mean change HbA1c. = -0.27, CI. = -0.44, 0.11) and long-term (10 studies; mean change HbA1c. = -0.23, CI. = -0.44, -0.02) glycemic improvement. Conclusions: Group visits may improve self-efficacy and glycemic control. There was little consistent evidence of improved quality of life, functional status, or utilization. Practice implications: Group visits represent a reasonable alternative for educating patients with chronic illness, though varied participation/retention suggests they should not be the sole alternative.
AB - Objective: Review the effectiveness of group visits (appointments of multiple patients) on quality of life, function, self-efficacy, utilization, and biophysical outcomes in randomized controlled trials of patients with chronic conditions. Methods: We searched MEDLINE®, Cochrane, CINAHL, and PsycINFO to January 2013 for English-language trials of educational group visits led by non-prescribing facilitators (e.g., peer educators). Results: We report on 80 arthritis/falls (n= 22), asthma/COPD (n= 10), CHF/hypertension (n= 12), diabetes (n= 29), multiple conditions (n= 4), and pain (n= 4) studies. We found moderate evidence of improved short-term self-efficacy in patients with arthritis (10 studies) and diabetes (10 studies). We found no consistent evidence of improved quality of life; however a moderately strong body of evidence suggests peer-led community-based programs might improve quality of life and utilization in patients with multiple chronic conditions. Meta-analyses found short- (14 studies; mean change HbA1c. = -0.27, CI. = -0.44, 0.11) and long-term (10 studies; mean change HbA1c. = -0.23, CI. = -0.44, -0.02) glycemic improvement. Conclusions: Group visits may improve self-efficacy and glycemic control. There was little consistent evidence of improved quality of life, functional status, or utilization. Practice implications: Group visits represent a reasonable alternative for educating patients with chronic illness, though varied participation/retention suggests they should not be the sole alternative.
KW - Chronic disease
KW - Chronic disease self-management
KW - Group visits
KW - Health education
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U2 - 10.1016/j.pec.2013.12.021
DO - 10.1016/j.pec.2013.12.021
M3 - Review article
C2 - 24468199
AN - SCOPUS:84896314729
SN - 0738-3991
VL - 95
SP - 3
EP - 29
JO - Patient Education and Counseling
JF - Patient Education and Counseling
IS - 1
ER -