Article Text
Abstract
Our team examined the characteristics of patient engagement (PE) practices in exercise-based randomized trials in type 1 diabetes (T1D), and facilitated T1D stakeholders in determining the top 10 list of priorities for exercise research. Two methodological approaches were employed: a scoping review and a modified James Lind Alliance priority-setting partnership. Published (Medline, Embase, CINAHL and Central databases) and grey literature (www.clinicaltrials.gov) were searched to identify randomized controlled trials of exercise interventions lasting minimum 4 weeks and available in English. We extracted information on PE and patient-reported outcomes (PROs) to identify if patient perspectives had been implemented. Based on results, we set out to determine exercise research priorities as a first step towards a patient-engaged research agenda. An online survey was distributed across Canada to collect research questions from patients, caregivers and healthcare providers. We qualitatively analyzed submitted questions and compiled a long list that a 12-person stakeholder steering committee used to identify the top 10 priority research questions. Of 9962 identified sources, 19 published trials and 4 trial registrations fulfilled inclusion criteria. No evidence of PE existed in any included study. Most commonly measured PROs were frequency of hypoglycemia (n=7) and quality of life (n=4). The priority-setting survey yielded 194 submitted research questions. Steering committee rankings identified 10 priorities focused on lifestyle factors and exercise modifications to maintain short-term glycemic control. Recent exercise-based randomized trials in T1D have not included PE and PROs. Patient priorities for exercise research have yet to be addressed with adequately designed clinical trials.
- patient-oriented research
- type 1
- exercise
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Footnotes
Contributors NMDK, JMMG, NA, AM and NB all contributed to the conduct of the scoping review. NMDK, JMMG, TAD, KMS, SDM, JEY, JLH and NB contributed to the priority-setting project, in varying capacities including project planning, data collection and recruitment and data analysis. All authors contributed to writing or editing this manuscript.
Funding This study was supported by funding from the Canadian Institutes of Health Research Strategy for Patient-Oriented Research (SCA-145101) and an Applied Public Health Chair in Resilience and Obesity in Youth held by Dr McGavock.
Competing interests JLH was supported by a CIHR Vanier Scholarship. KMS holds a Canada Research Chair in Integrated Knowledge Translation in Rehabilitation Sciences. JEY received personal fees and/or non-financial support from Dexcom Canada, Abbott Nutrition Canada and LifeScan Canada, outside the submitted work. NMDK was supported by a University of Manitoba Graduate Fellowship award.
Patient consent for publication Not required.
Ethics approval Ethics approval was not required for the scoping review. The priority-setting study was approved by the University of Manitoba Health Research Ethics Board (H2018:187).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available on reasonable request. The deidentified datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.