Search

Abstract Background To evaluate the efficacy of SIMBA as an educational intervention for both HCPs and people with either PCOS or adrenal conditions and to study the change in knowledge of people with PCOS or adrenal conditions about the conditions and expectations from the HCPs involved in their care following SIMBA-PPI sessions. Methods Two SIMBA-PPI sessions (SIMBA-PPI Polycystic ovary syndrome (SIMBA-PCOS) and SIMBA-PPI Adrenal conditions (SIMBA-Adrenal conditions)) were conducted in September 2021 and March 2022. In both sessions, HCPs interacted with moderators on patient management through WhatsApp. Patients with respective conditions underwent workshop-style learning in the same cases. SIMBA-PCOS transcripts were also translated into Brazilian Portuguese and workshops were held in both Brazilian Portuguese and English. The two groups (HCPs and patients) were then brought together to discuss exploring gaps in knowledge and expectations. The Wilcoxon Signed-Rank test compared differences in pre- and post-SIMBA self-reported confidence levels in HCPs and patients. Qualitative data from the online recordings were transcribed and analysed with inductive thematic analysis to identify gaps in knowledge and expectations from managing the cases. Results 48 HCPs and 25 patients participated in our study. When compared to pre-SIMBA confidence levels, SIMBA-PPI sessions effectively improved clinicians’ confidence in managing PCOS (40.5%, p

Introduction: The escalating prevalence of obesity worldwide increases the risk of chronic diseases and diminishes life expectancy with growing economic burden necessitating intervention.1 The existing tiered approach to weight management, particularly specialist Tier 3 services, falls short of meeting the population's needs. The emergence of digital health tools, while promising, lacks exploration in specialised NHS weight management services (WMS). Methods: This was a service evaluation study to evaluate the effectiveness and clinical impact of the W8Buddy digital support tool as part of a specialist WMS. W8buddy was collaboratively developed September 2022 with input from patients and clinical teams. It is a personalised platform, offering users a tailored weight management plan to empower individuals or caregivers to cultivate the necessary attitudes, knowledge, and skills to self-manage their health. All patients accessing the service were offered W8buddy and everyone received standard of care regardless of whether they used the digital tool. No financial incentives were given for using W8Buddy. Results: Complete data was available for 226 patients (118 users, 108 non-users). W8buddy users, predominantly female (80%) and Caucasian (76%), had a mean age of 42 years, while non-users averaged 48 years (p = 0.01). Co-morbidity frequencies were comparable between users and non-users. Users had significantly higher baseline weight (135 kg vs. 123 kg, p = 0.003) and BMI (48 kg/m² vs. 45 kg/m², p = 0.009). During follow-up (3 months for users, 6 months for non-users), 28% (n = 220/783) activated the tool by June 2023, of which 93% (n = 205/220) actively engaged with the platform. W8Buddy demonstrated a substantial impact on absolute weight loss (β -1.16, SE 0.40, p = 0.004) compared to standard care alone. Time using W8Buddy was a crucial predictor of weight loss (p = 0.05), with a 0.74 kg monthly loss compared to standard care (β -0.74, 95%CI (-1.28, -0.21), p = 0.007). W8buddy users with type 2 diabetes (T2DM) experienced a significant HbA1c reduction (59.8 mmol/mol to 51.2 mmol/mol, p = 0.018) compared to non-users with T2DM. Optional surveys evaluating psychological outcomes included satisfaction with life, PHQ8, Karolinska scale, and quality of life score (EQ5D5L). W8Buddy users showed significant improvement across all psychological outcomes (p

BackgroundDiabetes is a worldwide chronic condition causing morbidity and mortality, with a growing economic burden on health care systems. Complications from poorly controlled diabetes are associated with increased socioeconomic costs and reduced quality of life. Smartphones have become an influential platform, providing feasible tools such as health apps to deliver tailored support to enhance the ability of patients with diabetes for self-management. Gro Health is a National Health Service division X–certified digital health tool used to deliver educational and monitoring support to facilitate the development of skills and practices for maintaining good health. ObjectiveThis study aims to assess self-reported outcomes of the Gro Health app among users with diabetes and prediabetes and identify the factors that determine engagement with the digital health tool. MethodsThis was a service evaluation of self-reported data collected prospectively by the developers of the Gro Health app. The EQ-5D questionnaire is a standardized tool used to measure health status for clinical and economic appraisal. Gro Health users completed the EQ-5D at baseline and 6 months after using the app. Users provided informed consent for the use of their anonymized data for research purposes. EQ-5D index scores and visual analogue scale (VAS) scores were calculated at baseline and 6 months for individuals with prediabetes and type 2 diabetes. Descriptive statistics and multiple-regression models were used to assess changes in the outcome measures and determine factors that affected engagement with the digital tool. ResultsA total of 84% (1767/2114) of Gro Health participants completed EQ-5D at baseline and 6 months. EQ-5D index scores are average values that reflect people’s preferences about their health state (1=full health and 0=moribund). There was a significant and clinically meaningful increase in mean EQ-5D index scores among app users between baseline (0.746, SD 0.23) and follow-up (0.792, SD 0.22; P

The rising prevalence of paediatric type 2 diabetes (T2D) is concerning, particularly with limited medical intervention despite evidence of accelerated disease progression. This study of a Barts Health NHS Trust cohort from 2008 to 2022 aims to elucidate the incidence, clinical outcomes, and complications associated with paediatric T2D. A retrospective analysis utilising electronic and paper records identified 40 patients with T2D. The incidence doubled from 2.6/year in 2008–2013 to 5.4/year in 2014–2018. Sixty-eight percent exhibited co-morbidities, notably learning disabilities. At diagnosis, the mean BMI was 32.4 ± 6.71 kg/m2, with no gender-based disparity and no significant change over a two-year follow-up. The initial HbA1c was 75.2 ± 21.0 mmol/mol, decreasing to 55.0 ± 17.4 mmol/mol after three months (p = 0.001) and then rising to 63.0 ± 25.5 mmol/mol at one year (p = 0.07). While 22/37 patients achieved HbA1c < 48 mmol/mol, only 9 maintained this for a year. Several metabolic and cardiovascular complications were observed at diagnosis and follow-up, with no significant change in frequency. In 2022, 15 patients transitioned to adult services. HbA1c at transition was 74.7 ± 27.6 mmol/mol, showing no change one year post-transition (71.9 ± 26.9 mmol/mol, p = 0.34). This study highlights substantial therapeutic failure, with current management falling short in achieving a sustained reduction in BMI or HbA1c. Novel treatment approaches are needed to improve clinical outcomes and address the high burden of co-morbidities and complications.