Background: self-management interventions (SMI) are complex interventions, considered critical for a high-quality care for people with type 2 diabetes mellitus (T2DM). The incorporation of the perspective of patients and caregivers is essential for a successful implementation of SMIs.
Objectives: to identify, appraise and analyse currently available evidence addressing the perspective of people with T2DM and their caregivers on SMI. We specifically aim to:
1) explore how people with T2DM value the importance of outcomes of SMI, and;
2) identify contextual factors that impact on SMI feasibility or acceptability from the perspective of people with T2DM and their caregivers.
This is one of four mixed-method overviews of COMPAR-EU, a European Project aimed to identify and rank the most cost-effective SMI for four chronic conditions.
Methods: we searched MEDLINE, CINAHL and PsycINFO up to November 2018, for both quantitative and qualitative systematic reviews (SRs). Two authors independently screened references for inclusion and sought additional records using forward citation of selected SRs in Scopus, hand-searching references of previous overviews, and PubMed automatic search updates up to March 2019. We assessed the quality of included SRs with the Joanna Briggs Institute Critical Appraisal Checklist, calculated the extent of overlap of primary studies, and codified findings guided by the SMI taxonomy developed in the COMPAR-EU Project. We used a convergent parallel approach for the synthesis of results.
Preliminary results: we identified over 2900 references, including a total of 53 SRs (Fig 1). Of these, 26% (14/53) explored preferences about specific SMIs, and 74% (39/53) the experience of living with T2DM. Most were published in 2010 or later (49/53, 92%), and conducted in Europe (28/53, 53%) (Table 1). Almost half of the SRs focused specifically on T2DM (27/53, 51%), while the rest had a broader scope, including T1DM or other diseases. Overall quality of the included SRs was 82%, and calculated overlap was 0.55%. Most of the reviews were qualitative evidence synthesis (20/53, 38%) or mixed-methods reviews (20/53, 38%). We are currently starting the process of data synthesis and results will be presented at the Colloquium.
Conclusions: we will present an overview of main findings across quantitative, qualitative and mixed methods SRs, about the perspective of people with T2DM and their caregivers on SMI and the experience of living with this disease, followed by a structured assessment of quality of the included reviews and overlap of primary studies, and suggest how these results may inform the SR research agenda.
Patient or healthcare consumer involvement: this overview reflects the perspective of people living with T2DM and their caregivers, and it is a summary of the body of evidence available in SRs. In addition, we will collect feedback from COMPAR-EU Consortium members who represent other relevant stakeholders.