Podiatry
Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/7
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Item Enablers and barriers of e-learning utilising smart technologies in type 2 diabetes care for clinicians: a systematic review(BMJ, 2025-11-16) Alanazi, Maha Mouidh; Fellas, Antoni; Bridge, Pascale; Acharya, Shamasunder; Santos, Derek; Sculley, Dean; Girones, Xavier; Coda, AndreaObjectives Continuous Glucose Monitoring (CGM) supports Type 2 Diabetes (T2D) management, but healthcare professionals (HCPs) often face challenges interpreting data. E-learning platforms can enhance knowledge, skills and confidence. This systematic review identified enablers and barriers to e-learning for CGM interpretation. Design Systematic review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data sources PubMed, Ovid MEDLINE, Ovid Embase, Cochrane Library, Scopus, Web of Science and CINAHL were searched on 7 February 2024. Eligibility criteria for selecting studies Studies of HCPs using e-learning for T2D management were included, both comparative and non-comparative. Outcomes included enablers and barriers. Eligible designs were randomised, quasi-experimental, controlled before-and-after and observational studies. No restrictions on setting or language; conference abstracts included if full text was available Data extraction and synthesis Two reviewers independently screened and extracted data using a predefined form; disagreements were resolved by a third reviewer. Thematic analysis identified key enablers and barriers. Methodological quality was assessed using the Downs and Black checklist, and findings were synthesised narratively. Results Four studies met inclusion criteria, including 6790 participants (physicians, nurses, midwives and medical residents). E-learning improved knowledge and skills. Emami et al reported increased knowledge of T2D diagnosis and treatment (p=0.001), while Okuroğlu and Alpar found improvements in diabetes care knowledge and skills (p<0.001). Harris et al noted enhanced self-reported performance (p=0.03) and 84% satisfaction. Enablers included flexibility and accessibility, while barriers involved time constraints, resistance to change and methodological limitations (self-selection bias, lack of blinding). Study quality ranged from fair (three studies) to poor (one study). Conclusion Based on current evidence, it is unclear if e-learning can significantly enhance HCPs’ knowledge, skills and confidence in T2D management. Barriers such as time constraints and resistance to change remain, and the limited number and quality of studies restrict the generalisability of these findings. E-learning may offer potential benefits, but further robust randomised controlled trials are needed to evaluate long-term outcomes and strategies to overcome these challenges.Item The role of SmartWatch Technology in the provision of care for type 1 or type 2 Diabetes Mellitus or Gestational Diabetes: a systematic review.(JMIR, 2023-12-03) Alvarez, Sergio; Fellas, Antoni; Wynne, Kate; Santos, Derek; Sculley, Dean; Acharya, Shamasunder; Navathe, Pooshan; Girones, Xavier; Coda, AndreaBackground: The use of Smart technology in the management of all forms of diabetes mellitus has grown significantly in the past ten years. Technologies such as the SmartWatch have been proposed as a method of assisting in the monitoring of blood glucose levels as well as other alert prompts such as medication adherence and daily physical activity targets. These important outcomes reach across all forms of diabetes and have the potential to increase compliance of self-monitoring with the aim of improving long term outcomes such as HbA1c. Objective: This systematic review aims to explore the literature for evidence of SmartWatch technology in type 1,2 and gestational diabetes. Methods: A systematic review was undertaken by searching Ovid MEDLINE and CINAHL databases. A second search using all identified keywords and index terms was performed on Ovid MEDLINE (January 1966 to August 2023), EMBASE (January 1980 to August 2023), Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, latest issue), CINAHL (from 1982), IEEE Xplore, and ACM Digital Libraries, and Web of Science databases. Results: Five studies were included for qualitative synthesis in this review, however, none of these studies were randomised clinical trials and published research is currently focusing on usability and feasibility. Conclusions: This systematic review has highlighted the lack of robust randomised clinical trials that explore the efficacy of SmartWatch technology in the management of patients with type 1, 2 and gestational diabetes.Item The clinical impact of flash glucose monitoring, a digital health application and smart watch technology in patients with type 2 diabetes: a scoping review(JMIR Publications, 2023-01-19) Alvarez, Sergio Diez; Fellas, Antoni; Santos, Derek; Sculley, Dean; Wynne, Katie; Acharya, Shamasunder; Xavier Girones; Girones, Xavier; Coda, AndreaBackground: Type 2 diabetes has a growing prevalence and confers significant cost burden to the health care system. Raising the urgent need for cost effective and easily accessible solutions. The management of type 2 diabetes requires significant commitment from the patient, caregivers and the treating team to optimise clinical outcomes and prevent complications. Technology and its implications for the management of type 2 diabetes is a nascent area of research. The impact of some of the more recent technological innovations in this space such as continuous glucose monitoring, flash glucose monitoring, web-based applications and smart phone and smart watch based interactive applications have received limited attention in the research literature. Objective: This scoping review aims to explore the literature available in type 2 diabetes, flash glucose monitoring and digital health technology to improve diabetic clinical outcomes and thus inform future research in this area. Methods: A scoping review was undertaken by searching Ovid MEDLINE and CINAHL databases. A second search using all identified keywords and index terms was performed on Ovid MEDLINE (January 1966 to July 2021), EMBASE (January 1980 to July 2021), Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, latest issue), CINAHL (from 1982), IEEE XPlore and ACM Digital Libraries, and Web of Science databases. Results: There were very few studies that have explored the use of mobile health and Flash glucose monitoring in type 2 diabetes. These studies have explored somewhat disparate and limited areas of research, and there is a distinct lack of methodological rigor in this area of research. The 3 studies that met the inclusion criteria have addressed aspects of the proposed research question. Conclusions: This scoping review has highlighted the lack of research in this area, raising the opportunity for further research in this area, focusing on the clinical impact and feasibility of the use of multiple technologies including flash glucose monitoring in the management of patients with type 2 diabetes.Item Exploring the Effectiveness of Smart Technologies in the Management of Type 2 Diabetes Mellitus(SAGE, 2017-05-25) Coda, Andrea; Sculley, Dean; Santos, Derek; Girones, Xavier; Acharya, ShamasunderThe global epidemic of diabetes, with increasing prevalence of type 2 diabetes (T2D), is placing a huge burden on health care management and financial systems. Unless new strategic solutions are developed, the increasing prevalence of T2D will result in a significant rise in morbidity, health care costs, and complications associated with diabetes. The introduction of smart devices in diabetes management may provide meaningful improvements in clinical outcomes, patient engagement, as well as potential cost reductions for the health care system. Future research may be capable of providing new smart and interactive solutions to the growing multidisciplinary diabetes team and, most important, to reduce the morbidity associated with T2D.