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. 2023 May 31;2023(5):CD014513. doi: 10.1002/14651858.CD014513

Liu 2012.

Study characteristics
Methods Effectiveness of using group visit model to support diabetes patient self‐management in rural communities of Shanghai: a randomized controlled trial
RCT (NA clusters and NA providers), conducted in 1) The trial was undertaken in 2 rural communities in Songjiang District, Shanghai, China. New community diabetes care service provided by the community health centre. 2) 8 general practice team members (general practitioners, diabetes specialists and community nurses) from the 2 community health centres delivered the intervention. In China.
2 arms: 1. Control (usual care) (control arm) and 2. Intervention (group visit programme) (intervention arm)
Participants Control arm N: 89
Intervention arm N: 119, NA, NA
Diabetes type: 2
Mean age: 62.20 ± NR
% Male: 37.97
Longest follow‐up: 12 months
Interventions Control arm: (usual care)
Intervention arm: (group visit programme)
1) Case management
2) Team change
3) Patient education
4) Promotion of self‐management
5) Patient reminders
Outcomes Systolic blood pressure
Diastolic blood pressure
Funding source The development of the Chinese diabetes group visit programme was supported by grants from the Initiative for Cardiovascular Health Research in Developing Countries (IC‐HEALTH) (ICH/DIA/PDG/O6/03)
Notes
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Randomisation and allocation to study group were carried out by using a random number table. Randomisation was conducted at each of the 2 rural communities separately.
Allocation concealment (selection bias) Unclear risk Not reported.
Patient's baseline characteristics (selection bias) Low risk Table 3. No P values reported, but the only significant difference was for hypertension prevalence (outcome).
Patient's baseline outcomes (selection bias) High risk Table 4. P values above 0.05 for systolic and diastolic blood pressure, but the prevalence of hypertension was significantly different between those in the intervention and control groups (P = 0.02).
Incomplete outcome data (attrition bias) High risk They lost 11 out of 89 patients (12.4%) in the control group and 21 out of 119 (17.6%) in the intervention group. High and unbalanced numbers. Reasons reported and some are unbalanced (moved out and unknown).
Blinding of participants and personnel (performance bias) and of outcome assessors (detection bias) Low risk Our outcomes of interest were objectively measured (SBP and DBP).
Selective reporting (reporting bias) Unclear risk Retrospectively registered protocol. Results match methods.
Risk of contamination (other bias) Unclear risk Not clear if GPs involved in the intervention also followed patients in the control group.
Other bias Low risk No evidence of other bias.