A cross-sectional time series of cardiometabolic health education format preferences across sociodemographic groups.

AIMS: Health education is integral to cardiometabolic disease (CMD) management. This study aimed to assess whether and how education preferences have changed over time, and whether trends differ by sociodemographic characteristics (education status, age, ethnicity, and sex). METHODS: A cross-sectional questionnaire was deployed across five counties in the East Midlands, UK between 2017 and 2022 to adults with CMD (type 2 diabetes, cardiovascular disease or cerebrovascular disease). Respondent demographic data were collected alongside health education preferences. Statistical analyses ascertained whether demographic characteristics influenced preferences. The distribution of preferences over time was charted to identify trends. RESULTS: A total of 4301 eligible responses were collected. Face-to-face one-to-one education was preferred (first choice for 75.1% of participants) but popularity waned over the five-year period. Trends were similar amongst demographic groups. Online education showed a U-shaped trend: In 2017, 44% of respondents ranked it as acceptable, peaking at 53% in 2019, but declining again, to below base line, 43%, by 2022. This modality was more popular with participants aged younger than 65 years, but popularity in people older than 65 years increased over the study period. The popularity of printed information also declined over time across all demographic groups except those of South Asian ethnicity, for whom it remained static. CONCLUSIONS: The overwhelming preference for face-to-face one-to-one health education from a doctor or nurse highlights the importance of preserving access to this modality, even in the face of current NHS pressures and trends towards digitalisation. Trends are changing, and should continue to be monitored, including between different sociodemographic groups.

Educational preferences in individuals with cardiometabolic disease differs with age, ethnicity and educational status.

OBJECTIVES: To evaluate how sociodemographic factors influence educational modality preferences in people with cardiometabolic disease. METHODS: This was a cross-sectional study performed in people with diabetes and cardiovascular disease, who completed a questionnaire to denote their previous experience and ranked preferences for different educational modalities. RESULTS: The questionnaire was completed by 3751 people, of whom 59% were men, median (interquartile range) age was 68 (59-76) years, and 78% were White European. In total, 73% had diabetes, 35% had heart disease, and 10% had history of stroke; the majority (83.4%) had one of these conditions. Overall preference was for one-to-one education (77% ranked first choice), and telephone education ranked the lowest. People tended to prefer modalities they had previously experienced. CONCLUSIONS: We highlight the importance of considering factors that could influence selection of educational modalities including age, ethnicity, gender and educational level. We anticipate this approach will aid in the design, delivery and tailoring of educational programmes that are accessible to the diverse cohort of people living with chronic diseases, including diabetes and cardiovascular disease. PRACTICE IMPLICATIONS: Given the influence of multiple demographic factors and previous experiences on expressed preferences, providers should support individuals to make informed decisions about educational interventions to maximise engagement.

What are the development priorities for management of type 2 diabetes by general practitioners in Ningbo, China: a qualitative study of patients' and practitioners' perspectives.

OBJECTIVES: To explore patients' and general practitioners' (GPs') perspectives on primary care management of patients with type 2 diabetes mellitus (T2DM) in Ningbo, China. We aimed to understand the current benefits and challenges and to identify development priorities. DESIGN: Exploratory qualitative descriptive study using face-to-face interviews and analysed by thematic, inductive analysis. SETTING: 11 primary care facilities spread across the city of Ningbo, China. PARTICIPANTS: 23 patients with T2DM and 20 GPs involved in caring for patients with T2DM. RESULTS: GPs were considered the first point of contact and providers of information. However, the care varied, and many GPs lacked confidence and felt overworked. The medication was a particularly weak area. The diagnostic screening commenced late, leading to crisis presentations. Patients were variably informed about their condition, contributing to poor adherence. CONCLUSIONS: Future developments of primary care for T2DM in Ningbo should centre around improving GP confidence and workload and patient education and adherence.

Online patient education interventions in type 2 diabetes or cardiovascular disease: A systematic review of systematic reviews.

AIMS: Online patient education is a growing form of support to patients with chronic conditions, including type 2 diabetes (Type 2 DM) and cardiovascular disease (CVD). Multiple systematic reviews have been undertaken on this topic with conflicting results. We aim to explore the applications of online patient education in Type 2 DM and CVD and synthesise current evidence. METHODS: A systematic review of systematic reviews was performed. Ovid Medline, EMBASE and Cochrane Database were searched between January 2005 and May 2018. Systematic reviews considering patient outcomes of online education interventions for adults with Type 2 DM and/or CVD were included. Quality assessment and data extraction was carried out in duplicate, and data combined using narrative synthesis. The PROSPERO registration number is CRD42016034018. RESULTS: Twenty-three systematic reviews were eligible, synthesizing evidence from 87 distinct primary studies. Six reviews were high quality, nine used meta-analysis. Biological, behavioural, psychological, knowledge and self-efficacy measures are all potential targets. The outcomes most consistently showing benefits were knowledge and social support. CONCLUSIONS: Online patient education has wide ranging benefits for people with Type 2 DM or CVD. Strengths of this review include its comprehensive synthesis of the large amount of literature on this topic.

Problem based review: The patient with a pyrexia of unknown origin.

Pyrexia of unknown origin (PUO) is a frequent presentation to the Acute Medical Unit, and is a source of significant morbidity, both the psychological burden of an uncertain diagnosis and prognosis and untreated complications of the underlying pathology. We present a problem based review of the management of PUO, illustrated by a patient who recently presented to our unit with fever and systemic malaise after returning from abroad and in whom no cause could be found for more than two months. We describe a structured approach making use of complex modern techniques such as Positron Emission Tomography-Computed Tomography (PET-CT) which ultimately provided the diagnosis for our patient.