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Mapping the components of the effective implementation of diabetes prevention programmes after gestational diabetes mellitus: a protocol for a scoping review

Por: Sushko · K. · Sherifali · D. · Smith · K. · Lipscombe · L. L.
Introduction

Women with a history of gestational diabetes mellitus (GDM) have a high lifetime risk of developing type 2 diabetes. Diabetes prevention programmes may reduce this risk. However, challenges related to the successful implementation of diabetes prevention programmes after GDM exist. Our objective is to map the components of the effective implementation of diabetes prevention programmes after GDM. We also plan to connect the available evidence on the effective implementation of diabetes prevention programmes to the Consolidated Framework for Implementation Research.

Methods and analysis

We will conduct a scoping review following Levac’s adaptation of Arksey and O’Malley’s framework for scoping reviews. We will report it according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Using a peer-reviewed search strategy, we will search Medline, Embase, PsycInfo and Emcare for primary studies describing the effective implementation of diabetes prevention programmes after GDM. Study selection will be completed in DistillerSR by two independent reviewers. Data will be extracted by one reviewer and verified by a second reviewer for accuracy using data extraction forms in DistillerSR.

Ethics and dissemination

Ethics approval was not required. Study results will be published in a peer-reviewed journal and presented at relevant conferences.

Study registration details

This scoping review protocol was registered with Open Science Framework (OSF; preregistration, 15 April 2024; registration ID: 10.17605/OSF.IO/MPNQD).

Qualitative study exploring stakeholder perspectives on the use of early MRI in wrist injury pathways in the UK NHS

Por: Dean · B. J. F. · Lang · G. · Baird · L. · Grove · A. · Stephens · T. · Toye · F. · Improving Wrist Injury Pathways Study Group · Scrimshire · Little · Riley · Metcalfe · Sellon · Burford · Cadoux-Hudson · Hedley · Gidwani · Brewster · Costa · Lawrie · Rankin · Lipscombe · Berridg
Objectives

Early MRI use varies in the management of acute wrist injuries in the UK, with only a minority of National Health Service (NHS) centres being able to offer this to patients. In this study, we aim to explore the perspectives of staff and patients on the use of early MRI in the management of wrist injuries.

Design

This is a cross-sectional qualitative study using semistructured, face-to-face and remote interviews. Interviews were audio recorded, transcribed verbatim and analysed using thematic analysis.

Setting

10 NHS Trusts in the UK.

Participants

We interviewed a sample consisting of 37 NHS staff members and 21 patients.

Results

We analysed the data into three overarching themes. The first theme described the negative impact of wrist injuries on both staff and patients. Staff reported an uncomfortable feeling that they had ‘short-changed’ patients with older non-MRI based pathways, and that the consequences of missing a scaphoid fracture could be a ‘horrible thing’ for patients. The second theme described how early MRI was perceived as a ‘win for everyone’. For patients, the win encompassed the relief of a speedy diagnosis which helped them to get better. Staff saw early MRI as a win because it ‘revolutionised care’ and ‘reduced the clinic footprint’. The final theme defined the key ingredients of delivering an early MRI pathway: a simple pathway with clear accountability, timely access to MRI and prompt reporting of results, a safe pathway with safety nets to avoid patients being lost, data and audit of the time to MRI and definitive treatment, bottom-up engagement, clear communication and looking after your team.

Conclusions

Our findings contribute to a better understanding of stakeholders’ perspectives on wrist injury pathways in the UK NHS.

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