Educational group visits for the management of chronic health conditions: A systematic review

Abstract Objective Review the effectiveness of group visits (appointments of multiple patients) on quality of life, function, self-efficacy, utilization, and biophysical outcomes in randomized controlled trials of patients with chronic conditions. Methods We searched MEDLINE® , Cochrane, CINAHL, and...

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Published in:Patient education and counseling 2014-04, Vol.95 (1), p.3-29
Main Authors: Quiñones, Ana R, Richardson, Jeannette, Freeman, Michele, Fu, Rochelle, O’Neil, Maya E, Motu’apuaka, Makalapua, Kansagara, Devan
Format: Article
Language:English
Subjects:
Arthritis
Chronic disease
Chronic Disease - therapy
Chronic disease self-management
Chronic obstructive pulmonary disease
Chronic sickness
Diabetes
Disease Management
Group visits
Health education
Humans
Internal Medicine
Nursing
Patient Education as Topic - methods
Patient Participation
Peer Group
Quality of Life
Randomized Controlled Trials as Topic
Self Care
Self Efficacy
Self-Help Groups
Selfefficacy
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Summary:Abstract Objective Review the effectiveness of group visits (appointments of multiple patients) on quality of life, function, self-efficacy, utilization, and biophysical outcomes in randomized controlled trials of patients with chronic conditions. Methods We searched MEDLINE® , Cochrane, CINAHL, and PsycINFO to January 2013 for English-language trials of educational group visits led by non-prescribing facilitators (e.g., peer educators). Results We report on 80 arthritis/falls ( n = 22), asthma/COPD ( n = 10), CHF/hypertension ( n = 12), diabetes ( n = 29), multiple conditions ( n = 4), and pain ( n = 4) studies. We found moderate evidence of improved short-term self-efficacy in patients with arthritis (10 studies) and diabetes (10 studies). We found no consistent evidence of improved quality of life; however a moderately strong body of evidence suggests peer-led community-based programs might improve quality of life and utilization in patients with multiple chronic conditions. Meta-analyses found short- (14 studies; mean change HbA1c = −0.27, CI = −0.44, 0.11) and long-term (10 studies; mean change HbA1c = −0.23, CI = −0.44, −0.02) glycemic improvement. Conclusions Group visits may improve self-efficacy and glycemic control. There was little consistent evidence of improved quality of life, functional status, or utilization. Practice implications Group visits represent a reasonable alternative for educating patients with chronic illness, though varied participation/retention suggests they should not be the sole alternative.
ISSN:0738-3991
1873-5134
DOI:10.1016/j.pec.2013.12.021