Macleod Center for Diabetes

United Kingdom

Macleod Center for Diabetes

United Kingdom
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Matthews L.,University of Glasgow | Kirk A.,University of Strathclyde | McCallum M.,Macleod Center for Diabetes | Mutrie N.,University of Edinburgh | And 2 more authors.
Practical Diabetes | Year: 2017

Physical activity is an important factor in diabetes management but is rarely implemented within routine diabetes care. The purpose of this process evaluation was to explore the feasibility of a 12-month pilot physical activity consultation intervention delivered for adults within routine diabetes care. A 12-month pilot physical activity consultation intervention was delivered, including face-to-face consultations at baseline, and at six and 12 months. Additional brief consultations were conducted monthly between baseline and six months via telephone, email or face-to-face. Consultations were led by a physical activity consultant trained and experienced in health psychology and lifestyle behaviour change. Multiple process evaluation measures were conducted including: interviews; email communication; online survey; and intervention session summaries. Additional outcomes explored participant characteristics (n = 89), attendance, adherence and the feasibility of collecting measurable outcomes for physical activity, BMI, HbA1c and psychological wellbeing. Appropriate methods and outcomes were used to facilitate implementation in a ‘real-life’ setting, as opposed to typical research settings. The intervention was feasible with high protocol fidelity, adoption by staff, and positive participant feedback. The role of ‘champions’ (consultant diabetologist and two health psychologists) was identified as a key factor in the positive evaluation of the intervention. Three changes were made to the intervention to address the complex support needs of the sample. Challenges were identified with collecting questionnaire data within the time allocation of consultations. Although not reaching statistical significance, findings suggest improvements in physical activity levels, BMI and several aspects of psychological wellbeing. It was concluded that physical activity consultation is a feasible method of promoting physical activity to adults with diabetes in routine diabetes care. The challenge lies in the translation of physical activity interventions for everyday practice while balancing the need for measurable outcomes with effective delivery. Copyright © 2017 John Wiley & Sons. Copyright © 2017 John Wiley & Sons, Ltd.


Marikar Bawa F.L.,University of Aberdeen | Mercer S.W.,University of Glasgow | Atherton R.J.,NHS Highland | Clague F.,Adult Psychological Therapies Service | And 3 more authors.
British Journal of General Practice | Year: 2015

Background: Chronic pain and its associated distress and disability are common reasons for seeking medical help. Patients with chronic pain use primary healthcare services five times more than the rest of the population. Mindfulness has become an increasingly popular selfmanagement technique. Aim: To assess the effectiveness of mindfulness-based interventions for patients with chronic pain. Design and setting: Systematic review and meta-analysis including randomised controlled trials of mindfulnessbased interventions for chronic pain. There was no restriction to study site or setting. Method: The databases MEDLINE® , Embase, AMED, CINAHL, PsycINFO, and Index to Theses were searched. Titles, abstracts, and full texts were screened iteratively against inclusion criteria of: randomised controlled trials of mindfulnessbased intervention; patients with non-malignant chronic pain; and economic, clinical, or humanistic outcome reported. Included studies were assessed with the Yates Quality Rating Scale. Meta-analysis was conducted. Results: Eleven studies were included. Chronic pain conditions included: fibromyalgia, rheumatoid arthritis, chronic musculoskeletal pain, failed back surgery syndrome, and mixed aetiology. Papers were of mixed methodological quality. Main outcomes reported were pain intensity, depression, physical functioning, quality of life, pain acceptance, and mindfulness. Economic outcomes were rarely reported. Meta-analysis effect sizes for clinical outcomes ranged from 0.12 (95% confidence interval [CI] = -0.05 to 0.30) (depression) to 1.32 (95% CI = -1.19 to 3.82) (sleep quality), and for humanistic outcomes 0.03 (95% CI = -0.66 to 0.72) (mindfulness) to 1.58 (95% CI = -0.57 to 3.74) (pain acceptance). Studies with active, compared with inactive, control groups showed smaller effects. Conclusion: There is limited evidence for effectiveness of mindfulness-based interventions for patients with chronic pain. Better-quality studies are required. ©British Journal of General Practice.

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