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of Chronic Conditions in Adults Evidence-based Synthesis Program

APPENDIX A. SEARCH STRATEGY

PubMed Searched on February 13, 2012

Set# (concept) Search Strategy Results

#1 (things being done) (((“Health Education”[Mesh]) OR “Self Care”[Mesh]) OR 

(lifestyle[Title/Abstract] OR counseling[Title/Abstract] OR 

“self[Title/Abstract] AND management”[Title/Abstract] OR 

“health[Title/Abstract] AND coaching”[Title/Abstract] OR 

“motivational[Title/Abstract] AND interviewing”[Title/Abstract] 

OR diet[Title/Abstract])) 

393676

#2 (diseases of interest) (hypertension[Title/Abstract] OR htn[Title/Abstract] OR 

chf[Title/Abstract] OR congestive[Title/Abstract] AND 

heart[Title/Abstract] AND failure[Title/Abstract] OR copd[Title/

Abstract] OR chronic[Title/Abstract] AND obstructive[Title/

Abstract] AND pulmonary[Title/Abstract] AND disease[Title/

Abstract] OR arthritis[Title/Abstract] OR pain[Title/Abstract] 

AND management[Title/Abstract] OR fall[Title/Abstract] 

AND risk[Title/Abstract]) OR ((((((“Hypertension”[Mesh]) 

OR “Heart Failure”[Mesh]) OR “Pulmonary Disease, Chronic Obstructive”[Mesh]) OR “Arthritis”[Mesh]) OR “Pain 

Management”[Mesh]) OR “Accidental Falls”[Mesh])) OR asthma OR “diabetes mellitus”[MeSH Terms] OR “diabetes”[Tiab] 

615989

#3 (group aspect) (((group[Title] OR groups[Title] OR share[Title] OR 

shared[Title]) OR (“Self-Help Groups”[Mesh])) NOT ((“shared 

decision making”) OR (“focus group”) OR (“food group”)))

163027

#4 (group aspect phrases) “group education” OR “group attention control” OR “group 

sessions” OR “group therapy” OR “education group” OR “group 

program” OR “group programme” OR “group programs” OR 

“group programmes” OR “group interventions” OR “group 

exercise” OR “small group” OR “group strategy” OR “group 

relaxation” OR “group teaching” OR “group work” OR “group 

learning” OR “multidisciplinary intervention” OR “interdisciplinary intervention” OR “group session” OR “group patient 

visit” OR “nurse-led shared care” OR “nurse facilitated group” 

OR “group clinic” OR “group based self management” OR “peer 

led self management” OR “group or usual care” OR “group 

care” OR “peer led”

46864

#5 (false phrases) “age group” OR “study group” OR “research group” OR “working group” OR “group practice” OR “group home” OR “youth 

group” OR “group foster home”

163923

#6 (group visits inclusive) #3 OR #4 203980

#7 #6 AND #2 AND #1 1133

#8 #7 NOT #5 979

After deduplication from previous 

search

817
68

Group Visits Focusing on Education for the Management

of Chronic Conditions in Adults Evidence-based Synthesis Program

CINAHL (EBSCO) searched Monday, February 13, 2012 4:18:16 PM

Concept Search Strategy Results

Things being done S8 S1 or S2 or S3 or S4 or S5 or S6 or S7 144186

S7 (MH “Diet+”) 49615

S6 (MH “Motivational Interviewing”) 758

S5 “health coaching” 68

S4 “self management” 4061

S3 (MH “Peer Counseling”) OR “lifestyle counseling” 618

S2 (MH “Self Care+”) 23157

S1 (MH “Health Education+”) 77695

144186

Diseases of interest S18 S9 or S10 or S11 or S12 or S13 or S14 or S15 or S16 or 

S17 125262

S17 (MH “Accidental Falls”) OR “accidental falls” 10196

S16 “pain management” 6993

S15 (MH “Arthritis”) OR “arthritis” 21888

S14 (MH “Pulmonary Disease, Chronic Obstructive+”) OR 

“copd” 8106

S13 (MH “Heart Failure+”) OR “congestive heart failure”

19227

S12 “chf” 1736

S11 “htn” 153

S10 (MH “Hypertension”) OR “hypertension” 41268

S9 (MH “Asthma+”) OR “asthma” OR (MH”Diabetes+”) 

OR “diabetes” 22332

125262

Group S44 S19 or S21 or S23 or S24 or S25 or S26 or S27 or S28 

or S29 or S30 or S31 or S32 or S33 or S34 or S35 or S36 or S37 

or S38 or S39 or S40 or S41 or S42 or S43 11958

S43 “group care” 103

S42 “group or usual care” 107

S41 “peer led self management” 7

S40 “group based self management” 5

S39 “group clinic” 12

S38 “nurse-led shared care” 7

S37 “group patient visits” 2

S36 “interdisciplinary intervention” 32

S35 “multidisciplinary intervention” 82

S34 “group learning” 167

S33 “group work” 701

S32 “group teaching” 114

S31 “group relaxation” 6

S30 “group strategy” 13

S29 “small group” 1763

S28 “group exercise” 692

S27 “group intervention” 794

S26 “group programme” 105

S25 “group program” 165

S24 “education group” 231

S23 “group therapy” 889

S22 “”group sessions” 0

S21 “group attention control” 2

S20 “”group education”” 0

S19 (MH “Group Exercise”) OR (MH “Support Groups+”) 7180

11958
69

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of Chronic Conditions in Adults Evidence-based Synthesis Program

Concept Search Strategy Results

False Phrases S55 S45 or S46 or S47 or S48 or S49 or S50 or S51 or S52 

or S53 or S54 20032

S54 “group foster home” 0

S53 “youth group” 14

S52 “group home” 142

S51 “group practice” 1642

S50 “working group” 1276

S49 “research group” 597

S48 “study group” 4509

S47 “food group” 180

S46 “focus group” 5757

S45 “age group” 6066

20032

S8 and S18 and S44 128 128

S57 S56 NOT S55 123 123

After deduplication from previous 

searches

90

Database: PsycINFO <1806 to February Week 1 2012>

Concept Search Strategy

Things being done 1 exp Health Education/ (12448)

2 exp Self Management/ or exp Health Promotion/ or exp Disease 

Management/ (17441)

3 exp Lifestyle/ or lifestyle counseling.mp. (6652)

4 health coaching.mp. (37)

5 exp Motivational Interviewing/ (800)

6 1 or 2 or 3 or 4 or 5 (35296)

Diseases of interest 7 asthma.mp. or exp Asthma/ (5016)

8 exp Hypertension/ or hypertention.mp. (4665)

9 exp Heart Disorders/ or congestive heart failure.mp. (9041)

10 copd.mp. or exp Chronic Obstructive Pulmonary Disease/ (951)

11 exp Rheumatoid Arthritis/ or exp Arthritis/ or arthritis.mp. or exp diabetes 

mellitus/ or diabetes.mp. (4170)

12 pain management.mp. or exp Pain Management/ (7290)

13 exp Falls/ or accidental falls.mp. (1089)
70

Group Visits Focusing on Education for the Management

of Chronic Conditions in Adults Evidence-based Synthesis Program

Concept Search Strategy

Group 15 exp Group Discussion/ or exp Group Counseling/ (7568)

16 “group education”.mp. (252)

17 “group attention control”.mp. (2)

18 “group sessions”.mp. (1970)

19 “group therapy”.mp. (10895)

20 “education group”.mp. (419)

21 “group programme”.mp. (109)

22 “group program”.mp. (703)

23 “group intervention”.mp. (1995)

24 “group exercise”.mp. (164)

25 “small group”.mp. (6780)

26 “group strategy”.mp. (42)

27 “group relaxation”.mp. (55)

28 “group teaching”.mp. (174)

29 “group work”.mp. (3647)

30 “group learning”.mp. (698)

31 “multidisciplinary intervention”.mp. (104)

32 “interdisciplinary intervention”.mp. (46)

33 “group session”.mp. (492)

34 “group patient visits”.mp. (3)

35 “nurse-led shared care”.mp. (3)

36 “group clinic”.mp. (14)

37 “group based self-management”.mp. (3)

38 “peer led self management”.mp. (6)

39 “group or usual care”.mp. (5)

40 “group or usual care”.mp. (5)

41 “group care”.mp. (414)

42 “peer led”.mp. (356)

43 15 or 16 or 17 or 18 or 19 or 20 or 21 or 22 or 23 or 24 or 25 or 26 or 27 

or 28 or 29 or 30 or 31 or 32 or 33 or 34 or 35 or 36 or 37 or 38 or 39 or 40 or 

41 or 42 (32430)

False Phrases 44 “study group”.mp. (2935)

45 “age group”.mp. (8248)

46 “research group”.mp. (1167)

47 “working group”.mp. (897)

48 “group practice”.mp. (456)

49 “group home”.mp. (782)

50 “youth group”.mp. (122)

51 “group foster home”.mp. (8)

52 44 or 45 or 46 or 47 or 48 or 49 or 50 or 51 (14552)

53 6 and 14 and 43 (55)

54 53 not 52 (55)

Deduplication N=44 unique
71

Group Visits Focusing on Education for the Management

of Chronic Conditions in Adults Evidence-based Synthesis Program

Database: EBM Reviews - Cochrane Central Register of Controlled Trials <January 2012>

Concept Search Strategy

Things being done 1 exp Health Education/ (7370)

2 exp Self Management/ or exp Health Promotion/ or exp Disease 

Management/ (5010)

3 exp Lifestyle/ or lifestyle counseling.mp. (1877)

4 health coaching.mp. (12)

5 exp Motivational Interviewing/ (0)

6 1 or 2 or 3 or 4 or 5 (12310)

Disease of interest 7 asthma.mp. or exp Asthma/ (18081)

8 exp Hypertension/ or hypertention.mp. (12184)

9 exp Heart Disorders/ or congestive heart failure.mp. (2610)

10 copd.mp. or exp Chronic Obstructive Pulmonary Disease/ (5428)

11 exp Rheumatoid Arthritis/ or exp Arthritis/ or arthritis.mp. or exp diabetes 

mellitus or diabetes.exp(8528)

12 pain management.mp. or exp Pain Management/ (1220)

13 exp Falls/ or accidental falls.mp. (617)

14 7 or 8 or 9 or 10 or 11 or 12 or 13 (47973)

Group 15 exp Group Discussion/ or exp Group Counseling/ (0)

16 “group education”.mp. (203)

17 “group attention control”.mp. (15)

18 “group sessions”.mp. (445)

19 “group therapy”.mp. (905)

20 “education group”.mp. (289)

21 “group programme”.mp. (70)

22 “group program”.mp. (188)

23 “group intervention”.mp. (1350)

24 “group exercise”.mp. (428)

25 “small group”.mp. (662)

26 “group strategy”.mp. (8)

27 “group relaxation”.mp. (40)

28 “group teaching”.mp. (42)

29 “group work”.mp. (65)

30 “group learning”.mp. (42)

31 “multidisciplinary intervention”.mp. (50)

32 “interdisciplinary intervention”.mp. (18)

33 “group session”.mp. (86)

34 “group patient visits”.mp. (1)

35 “nurse-led shared care”.mp. (3)

36 “group clinic”.mp. (27)

37 “group based self-management”.mp. (4)

38 “peer led self management”.mp. (1)

39 “group or usual care”.mp. (156)

40 “group or usual care”.mp. (156)

41 “group care”.mp. (50)

42 “peer led”.mp. (128)

43 15 or 16 or 17 or 18 or 19 or 20 or 21 or 22 or 23 or 24 or 25 or 26 or 27 or 

28 or 29 or 30 or 31 or 32 or 33 or 34 or 35 or 36 or 37 or 38 or 39 or 40 or 41 

or 42 (4846)
72

Group Visits Focusing on Education for the Management

of Chronic Conditions in Adults Evidence-based Synthesis Program

Concept Search Strategy

False phrases 44 “study group”.mp. (10409)

45 “age group”.mp. (1455)

46 “research group”.mp. (752)

47 “working group”.mp. (210)

48 “group practice”.mp. (165)

49 “group home”.mp. (82)

50 “youth group”.mp. (5)

51 “group foster home”.mp. (0)

52 44 or 45 or 46 or 47 or 48 or 49 or 50 or 51 (12995)

53 6 and 14 and 43 (175)

54 53 not 52 (167)
73

Group Visits Focusing on Education for the Management

of Chronic Conditions in Adults Evidence-based Synthesis Program

APPENDIX B. INCLUSION AND EXCLUSION CRITERIA

This criteria is for use in screening full-text articles to address the following key questions:

KQ1. In adults with chronic medical conditions, how do group visits compared to usual care 

affect the following:

(1) medication adherence, biophysical markers [laboratory markers of health states (e.g., 

HbA1c) or physiological measures (e.g., blood pressure)]

(2) symptom status, functional status, disease-specific or all-cause mortality, patient satisfaction

(3) utilization of medical resources, health care costs

(4) adverse outcomes (e.g., patient confidentiality, participation/missed appointments)?

KQ2. For adults with chronic medical conditions, do the effects of group visits vary by patient 

characteristics? Characteristics of interest include medical diagnosis, severity of disease, and 

comorbidities.

KQ3. (Depending on the size and comparability of elements identified in the literature) Which 

components of group visits are associated with greater intervention effects?

1. Is the full text of the article in English?

Yes.................................................................................................................Proceed to #2

No.............................................................................................................Code X1. STOP

2. Is the article a primary study that presents findings based on original data collection; or a 

systematic review of primary studies?

Yes.................................................................................................................Proceed to #3

No.........................................................................................................Code X2. Go to #6

3. Does the study population include adults with chronic medical conditions, specifically DM, 

HTN, CHF, COPD, asthma, arthritis, pain management, or history of falls?

Yes.................................................................................................................Proceed to #4

No.........................................................................................................Code X3. Go to #6

4. Does the study evaluate the effects of an intervention consisting of group visits led by nonprescribing facilitators (e.g., dietitians, nurses, social workers, peer educators, psychologists, pulmonary technicians, physical therapists)? Group visits may include prescribing 

practitioners (e.g., pharmacists, nurse practitioners, physician assistants, physicians) if they 

function in an advisory capacity only and do not provide individual care plans or medication management.

Yes.................................................................................................................Proceed to #5

No, not a group visit intervention ........................................................Code X4. Go to #6

No, a group visit that includes individualized treatment by a prescribing 

provider...................................................................................................... Code X4-SMA

No, a group visit in the diabetes mellitus clinical area that was published 

prior to the 1998 UKPDS study......................................................Code X4-pre UKPDS
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of Chronic Conditions in Adults Evidence-based Synthesis Program

5. Is the study design one of the following:

An RCT or a systematic review/meta-analysis that includes RCTs.........................Code I

An observational/quasi-experimental study........................................................... Code O

None of the above ........................................................................Code X5. Proceed to #6

6. Is the article potentially useful for background, discussion, or reference-mining?

Yes....................................................................................................... Add code B. STOP

No.............................................................................................................................. STOP

Codes to use for abstract screening: 

X = Exclude

B = Background

I = Include

O = Observational quasi/experimental study

SMA = Not relevant for Group Visits but may be useful for review of Shared Medical Appointments

PICOTS

Patients – Patients with DM, HTN, CHF, COPD, asthma, arthritis, pain management, history of 

falls.

Exclude comorbid serious mental illness such as schizophrenia. Studies with patients who have 

comorbid depression may be included.

Intervention – Group visits led by individuals who are non-prescribing health professionals and

lay facilitators (e.g., dietitians, nurses, social workers, peer educators, psychologists, pulmonary

technicians, physical therapists). Group visits may include prescribing providers (e.g., physicians,

pharmacists, advanced practice nurses, physician assistants) if they function in an advisory

capacity only (i.e., do not provide individual care plans or medication management).

Exclude the following: 

• support groups with no education component 

• multicomponent interventions for which a group visit is an optional but not required element

• multicomponent interventions that contain a required group visit but the independent 

effects of the group visit component cannot be evaluated separately 

• interventions that focus on completion of established exercise or relaxation modalities 

(e.g. yoga, tai chi, meditation classes) with no education component. However, a group 

visit that teaches and/or demonstrates tailored exercises would be included. 

Comparator – Usual care, non-group visit care

Outcome – Biophysical markers (HbA1c, lipids); physiological measures (BP); control of 

these markers/measures; rehospitalizations; medication adherence; ED visits; functional status; 

patient satisfaction; patient participation; attrition rates; utilization of medical resources, health 

care costs; and adverse outcomes.

Timing – To be determined. We may want to allow for sufficiently long group visit 

interventions to observe differences between groups

Setting – Any
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APPENDIX C. QUALITY ASSESSMENT

Definition of “good,” “fair,” and “poor” designations

Studies rated “good” have the least risk of bias, and results are considered valid. Good-quality 

studies include clear descriptions of the population, setting, interventions, and comparison 

groups; a valid method for allocation of patients to treatment; low dropout rates and clear 

reporting of dropouts; appropriate means for preventing bias; and appropriate measurement of 

outcomes.

Studies rated “fair” are susceptible to some bias, but it is not sufficient to invalidate results. 

These studies do not meet all the criteria for a “good” quality rating, but there is no indication 

that study flaws are likely to cause major bias. The study may be missing information, making 

it difficult to assess limitations and potential problems. The “fair” quality category is broad, and 

studies in this category can vary in their strengths and limitations. The results from fair studies 

range from valid to probably valid.

Studies rated “poor” have substantial flaws that imply biases in various rated categories that may 

invalidate results. They have a serious or “fatal” flaw in design, analysis, or reporting, including: 

large amounts of missing information, discrepancies in reporting, or raise serious concerns about 

the delivery of the intervention. The results of these studies are as likely to reflect flaws in the 

study design as they are to reflect true differences between compared groups. We did not exclude 

studies rated poor quality a priori, but poor quality studies were considered to be less valid than 

higher-quality studies when synthesizing the evidence, particularly when discrepancies between 

studies were present.
76

tion for the Management

Evidence-based Synthesis Program

sessment and methodological characteristics of individual studies in randomized controlled trials of group visits

ection:

ndom 

uence

Selection:allocation 

concealment

Blinding:

participants

Blinding:

personnel

Detection:

assessors 

blinded

Attrition: 

address 

missing

Reporting:

no selective 

reporting

Participation 

(% enrolled 

among 

eligible 

individuals)

Attrition 

(% loss to 

followup 

among N 

randomized)

Study 

quality

(Good/ 

Fair/ 

Poor)

nclear Unclear No No Unclear Unclear Unclear 71 38 Poor

Yes Yes No No No Yes Yes 25 22 Fair

nclear Yes Unclear Unclear Unclear Yes Yes 53 13 Fairnclear Unclear No No Unclear Yes Unclear NA* 3 Poornclear Unclear Unclear Unclear Unclear Yes Yes NA* 6 Poor

Yes Yes No No Yes Yes Yes 55 23 Fair

nclear No No No No NR Yes NR NR Poor

Yes Unclear No No Unclear Yes Yes NR 0 PoorYes Yes Unclear Unclear Unclear Yes Yes NR 22 FairYes Yes Unclear Unclear Unclear Yes Yes NR 16 Fair

nclear Unclear Unclear Unclear Yes Yes Yes 45 7 Fair

Yes Yes No No Yes Yes Yes NR 6 Good

nclear Unclear No No Unclear No No NR NR Poornclear Unclear Unclear Unclear Unclear Unclear Yes NR NR Poor

Yes Yes Unclear Unclear Unclear Yes Yes 30 24 FairYes Unclear No No No Yes Yes 17 13 FairYes Unclear No No Yes Yes Yes NA* 15 Good

Yes Yes Yes No No Yes Yes 20 32 Fair

Yes Yes No No Yes Yes Yes 78 5 Good

nclear Unclear Unclear Unclear Unclear No Yes 13 55 Poor

Yes Unclear No No Unclear Yes Yes 41 11 Fair

nclear Unclear Unclear Unclear N/A Yes Yes 26 10 Poornclear Unclear Unclear No Unclear Yes Yes NA* 13 Fair

Yes Yes Unclear Unclear Yes Yes Yes 53 17 FairYes Yes Unclear Unclear Yes Yes Yes NR 17 Good

nclear Unclear Unclear Unclear Yes Unclear Yes 94 23 Fair

Yes No No No No Yes Yes NA* 13 Fair
77

tion for the Management

Evidence-based Synthesis Program

ection:

ndom 

uence

Selection:allocation 

concealment

Blinding:

participants

Blinding:

personnel

Detection:

assessors 

blinded

Attrition: 

address 

missing

Reporting:

no selective 

reporting

Participation 

(% enrolled 

among 

eligible 

individuals)

Attrition 

(% loss to 

followup 

among N 

randomized)

Study 

quality

(Good/ 

Fair/ 

Poor)

Yes Yes Unclear Unclear Yes Unclear Yes 18 9 FairYes Yes No Yes Yes Yes Yes 84 20 Good

nclear Unclear No No Yes Yes Yes NR 31 Fair

Yes Yes No No Unclear Yes Yes 46 37 Fair

nclear Unclear Unclear Unclear Unclear Yes Yes NR 33 Poornclear Unclear Unclear Unclear Unclear Yes Yes NA* 30 Poor

Yes Yes No No Yes Yes Yes 15 24 Good

nclear Unclear No No No Yes Yes NR 14 Fairnclear Unclear Unclear Unclear Yes Yes Yes NR 35 Poor

Yes Yes Unclear Unclear Unclear Yes Yes NA* 11 Good

nclear Unclear Unclear Unclear Unclear Yes Yes 50 6 Fair

Yes Yes No No Yes Yes Yes 19 55 Good

nclear Unclear Unclear Unclear Unclear Yes Yes NA* 16 Fairnclear Unclear Unclear Unclear Unclear Yes Yes NR 17 Poornclear Unclear Unclear Unclear Yes Unclear Yes NR 51 Fair

Yes Unclear No Yes Yes Yes Yes 84 32 Good

nclear Unclear No No Unclear Yes Yes NA* 15 Fairnclear Unclear No No Yes Yes Yes NR 6 Fair

Yes Unclear Unclear Unclear Unclear Yes Yes NA* 11 FairYes Unclear No No Unclear Yes Yes NA* 6 FairYes Yes No No No Yes Yes 50 19 Fair

nclear Unclear No No Unclear Yes Yes 36 0 Poor

Yes Yes No No Yes Yes Yes NA* 16 GoodYes Yes Unclear Unclear Unclear Yes Yes 30 24 FairYes Yes No No Probably No Yes NR 25 Poor

nclear Unclear Unclear Unclear Unclear Unclear Unclear 33 NR Poor

No Unclear Unclear Unclear Unclear Unclear Yes NR 46 Poor

nclear Unclear Unclear Unclear Unclear Yes Yes 26 17 Fair
78

tion for the Management

Evidence-based Synthesis Program

ection:

ndom 

uence

Selection:allocation 

concealment

Blinding:

participants

Blinding:

personnel

Detection:

assessors 

blinded

Attrition: 

address 

missing

Reporting:

no selective 

reporting

Participation 

(% enrolled 

among 

eligible 

individuals)

Attrition 

(% loss to 

followup 

among N 

randomized)

Study 

quality

(Good/ 

Fair/ 

Poor)

Yes Unclear No No Yes Unclear Yes 57 16 FairYes Yes No No No Yes Yes 70 12 Poor

nclear Unclear Unclear Unclear Unclear Unclear Yes NR NR Poor

Yes Yes No No No Unclear Yes 91 9 FairYes Yes No No No Unclear Yes 92 17 Fair

nclear Unclear No No No Unclear Yes 86 0 Fair

Yes Unclear No No Unclear No Yes NR 42 PoorYes Unclear No No Unclear Yes Yes 73 10 FairYes Yes No No Yes Yes Yes NR 20 Good

nclear Unclear Unclear Unclear Unclear Unclear Unclear NR 3 Poor

Yes Yes Unclear Unclear Yes Yes Yes 88 5 Fair

Yes Yes No No Yes Yes Yes 44 16 Good

Yes Yes No No Yes Yes Yes 44 16 Good

nclear Unclear No No Unclear Unclear Unclear NR 5 Poornclear Unclear Unclear Unclear Unclear Yes Yes 82 2 Fair

No No Unclear Unclear Unclear Yes Yes 51 16 Poor

nclear Unclear Unclear Unclear Unclear Unclear Yes NR 24 Poor

Yes Yes No No Yes Unclear Unclear 56 12 Good

nclear Unclear Unclear Unclear Unclear No Yes 54 24 Poor

Yes No Unclear Unclear Yes Yes Yes 61 22 Fair

nclear Unclear Unclear Unclear Unclear Yes Yes NR 20 Fair

Yes Unclear Unclear Unclear Unclear Yes Yes 89 3 FairYes Yes No Yes Yes No Yes 56 14 FairYes Yes No No Unclear Unclear Yes 60 NR Fair

nclear Unclear Unclear Unclear Unclear Unclear Yes 100 0 Poor

; NR = not reported.

y eligible participants could not be calculated because subjects were recruited via community advertisement.
79

Group Visits Focusing on Education for the Management

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Table C2. Total number of outcome measures reported in studies of group visit interventions 

focusing on education for the management of chronic disease

Study Clinical 

area Category Outcomes/Measures Subscale

Total 

outcomes 

examined

Taal, 199344 Arthritis Anxiety/Depression VAS anxiety 20

depression

Functional status or 

disability

DUTCH-AIMS, M-HAQ disability

dexterity

household activities

physical activities

Health status HbA1c 

(marker disease activity)

N/A

Pain joint tenderness score (Richie et al. 1968) N/A

VAS arthritis impact

pain 

Self-efficacy activities (Lorig et al. 1989) N/A

endurance (Lorig et al. 1989) N/A

exercise (Lorig et al. 1989) N/A

function (five-point scale) N/A

other symptoms (five-point scale) N/A

pain (Lorig et al. 1989) N/A

relaxation (Lorig et al. (1989) N/A

VAS social activities

Biophysical ESR blood samples

thrombocytes N/A

Lorig, 200429 Arthritis Anxiety/Depression CESD N/A 8

Functional status or 

disability

ALS (role function) N/A

HAQ disability

Pain VAS N/A

Quality of life global severity arthritis N/A

Self-efficacy ASES N/A

Utilization total MD visits (last 6 mo) N/A

total rheumatology visits (last 6 mo) N/A

Lorig, 198540 Arthritis Exercise tolerance exercise (#/mo) N/A 7

relaxation (#/mo) N/A

Functional status or 

disability

Stanford Health Assessment 

Questionnaire (0-3 scale) disability

N/A

Pain pain (0-3 scale)

VAS N/A

Self-efficacy knowledge (0-10 scale) N/A

Utilization total MD visits (last 4 mo) N/A

Kaplan, 

198139

Arthritis Psychometric Human service scale 1 N/A 4

Tennessee self-concept scale 1 N/A

Self-efficacy knowledge N/A

Anxiety/Depression depression N/A
80

Group Visits Focusing on Education for the Management

of Chronic Conditions in Adults Evidence-based Synthesis Program

Study Clinical 

area Category Outcomes/Measures Subscale

Total 

outcomes 

examined

Hewlett, 

201138

Arthritis Pain VAS pain 13

Quality of life RAQol quality of life 

Self-efficacy AHI N/A

RASE N/A

VAS coping

Anxiety/Depression HADS anxiety

depression

Disease severity VAS disease activity

Fatigue MAF fatigue impact 

VAS fatigue impact 

Functional status or 

disability

HAQ disability 

PIHAQ impact disability 

VAS severity

Hammond, 

200847

Arthritis Anxiety/Depression HAQ anxiety 21

psychological distress

depression

Exercise tolerance self-management exercise N/A

Fatigue VAS fatigue 

Functional status or 

disability

early morning stiffness N/A

HAQ functional ability

Pain VAS pain

Self-efficacy cognitive symptom management N/A

AHI helplessness 

perceived control

ASCQ action

contemplation

maintenance

pre-contemplation

ASES Pain + other symptoms

perceived health (scale (0-100)) N/A

RASE N/A

Self-efficacy/ 

Functional status

fatigue management (scale 1-6) N/A

joint protection (scale 1-6) N/A

Utilization total MD visits (last 6-12 mo) N/A

Breedland, 

201133

Arthritis Exercise tolerance physical performance aerobic capacity 8

muscle strength LE

muscle strength UE

Health status Dutch-AIMS2 – health status physical health

psychological health

social interaction

Self-efficacy/

Functional status and 

disability/pain

ASES – self efficacy function

pain + other symptoms
81

Group Visits Focusing on Education for the Management

of Chronic Conditions in Adults Evidence-based Synthesis Program

Study Clinical 

area Category Outcomes/Measures Subscale

Total 

outcomes 

examined

Riemsma, 

200342

Arthritis Disease severity DAS28 (disease activity) N/A 20

Exercise tolerance health behavior (7 items on 5-point scale) endurance exercises

physical exercises

relaxation exercises

self-management

Fatigue VAS (fatigue) N/A

Functional status or 

disability/pain

AIMS2 physical function 

pain

Pain/Self-efficacy CORS coping with pain

Quality of life AIMS2 health status: affect

Self-efficacy social interactions (Revenson) emotional support

esteem support

informational support

overprotection

problematic support

tangible support

CORS coping with 

limitations

Self-efficacy/

Functional status and 

disability/ Pain

SES self-efficacy: 

other symptoms 

(depression, fatigue, 

frustration)

self-efficacy: function

self-efficacy: pain

GiraudetLe Quintrec, 

200737

Arthritis Anxiety/Depression HADS anxiety 16

depression

Disease severity DAS28 (disease activity) N/A

Exercise tolerance Baecke questionnaire physical activity 

Fatigue FACIT-F N/A

Knowledge rheumatoid arthritis knowledge (10-item) N/A

Patient satisfaction satisfaction with the program (Likert 

scale)

N/A

Quality of life EMIR (AIMS2) physical

psychological

social

symptomatic

work

HAQ quality of life: 

unweighted

quality of life: with 

weighting

Self-efficacy AHI (coping) N/A

Utilization EURIDISS drug compliance 

Sevick, 

200943

Arthritis Biophysical BMI N/A 7

Functional status, 

pain, disability

WOMAC degree of difficulty 

function

stiffness

pain 

Physical performance 6MWT N/A

stair climb N/A
82

Group Visits Focusing on Education for the Management

of Chronic Conditions in Adults Evidence-based Synthesis Program

Study Clinical 

area Category Outcomes/Measures Subscale

Total 

outcomes 

examined

Barlow, 

200032

Arthritis Anxiety/Depression HADS anxiety 12

depression

HADS, PANAS psychologic wellbeing 

Fatigue; pain VAS fatigue 

pain 

Pain/Self-efficacy ASE pain

Quality of life PANAS negative affect

positive affect

Self-efficacy ASE other symptoms

HAQ (dietary habit) N/A

Utilization communication with physician N/A

Buszewicz, 

200634

Arthritis Pain ASE other 8

pain

WOMAC pain

Quality of life SF-36 mental health 

Functional status or 

disability

WOMAC physical function

stiffness

Quality of life SF-36 physical health

Anxiety/Depression HADS anxiety

depression

Freeman, 

200236

Arthritis Functional status or 

disability

28 JC N/A 12

EMS N/A

Pain ESR (duration of early morning stiffness) N/A

VAS N/A

Quality of life AIMS2 affect

current health

physical functional 

ability 

symptoms

Self-efficacy ASES N/A

RAI helplessness 

internality

TSES N/A

Ettinger, 

199722

Arthritis Exercise tolerance aerobic capacity (0-3 Likert scale) N/A 10

aerobic training N/A

knee pain (1-6 Likert scale) N/A

physical performance endurance

distance (6MWT)

mobility

strength

resistance training N/A

Functional status or 

disability

self-reported disability (FAST, Likert 

scale)

N/A

Utilization x-ray N/A
83

Group Visits Focusing on Education for the Management

of Chronic Conditions in Adults Evidence-based Synthesis Program

Study Clinical 

area Category Outcomes/Measures Subscale

Total 

outcomes 

examined

Hammond, 

199923

Arthritis Functional status or 

disability

HAQ functional ability 11

HJAM (range of movement and joint 

deformity)

N/A

Pain HAQ hand pain

HJC (number of painful/tender hand 

joints)

N/A

VAS (hand pain) N/A

Physical performance grip strength N/A

Self-efficacy AHI N/A

ASES N/A

JP (self-reported homework) N/A

JPBA (joint protection behavior) N/A

JPKA (knowledge) N/A

Lorig, 199941 Arthritis Anxiety/Depression CESD depression 9

Exercise tolerance aerobic exercise N/A

range of motion exercise N/A

Functional status or 

disability

HAQ disability

Pain VNS (modified VAS) pain

Quality of life MOS general health/selfrated health

Self-efficacy HAQ self-efficacy

Utilization MD visits (last 6 mo) N/A

medication use (NSAIDs) N/A

Patel, 200935 Arthritis Costs VAS costs to patient, 

family, friends

11

indirect costs

social care costs

total costs, societal 

perspective

total health costs

Pain EQ-5D: VAS utility index

Quality of life EuroQol: VAS quality of life

QALYs quality adjusted life 

years

SF-36 mental health

physical health

cost effective on basis 

of QoL 
84

Group Visits Focusing on Education for the Management

of Chronic Conditions in Adults Evidence-based Synthesis Program

Study Clinical 

area Category Outcomes/Measures Subscale

Total 

outcomes 

examined

Ackerman, 

201231

Arthritis Pain WOMAC pain 15

Quality of life AQoL arthritis related quality 

of life

heiQ acquisition 

activity

attitudes/approaches

emotional distress

engagement

health service 

navigation 

self-monitoring

social integration/

support

HRQOL health related quality 

of life

Health status MAPT (arthritis disease severity) N/A

Functional status or 

disability

WOMAC physical function

stiffness

Anxiety/Depression K10 (distress) N/A

Wilson, 

199348

Asthma Exercise tolerance change in ph. activity (1 year) N/A 8

Health status # symptomatic days (1 year) N/A

asthma status (5 mo) N/A

relative “bother” (1 year) N/A

Self-management improved MDI technique (1 year) N/A

improvements bedr. environment (1 year) N/A

Utilization acute visit rates N/A

difference in acute visit rates N/A

Abdulwadud, 

199949

Asthma Quality of life AQLQ breathlessness 7

concern for health

mood disturbance

social disruption

Self-efficacy AGKQ knowledge

HAAS self-mgmt: rapid onset

self-mgmt: slow onset

Allen, 199550 Asthma Biophysical FEV/FVC adequacy of medical 

treatment

4

morbidity

Self-management compliance with meds N/A

Self-efficacy knowledge N/A

Bolton, 

199151

Asthma Functional status or 

disability

days of limited activity N/A 4

Utilization emergency room visits N/A

hospitalization N/A

physician visits N/A

Kritikos, 

2007101

Asthma Disease Severity asthma severity N/A 6

Quality of life AQLQ total quality of life

Self-management MARS medication adherence

Self-efficacy CQ knowledge

optimal DPI N/A

optimal MDI N/A
85

Group Visits Focusing on Education for the Management

of Chronic Conditions in Adults Evidence-based Synthesis Program

Study Clinical 

area Category Outcomes/Measures Subscale

Total 

outcomes 

examined

Snyder, 

198752

Asthma Disease severity symptom severity N/A 4

Self-efficacy ASES self-efficacy 

attitudes about asthma (AASA 24-item) N/A

BIQ (knowledge)

Wilson, 

200853

COPD Quality of life MRC (dyspnea) N/A 4

Self-efficacy abstinence from smoking validation, selfreport (IC)N/A

HSI (addiction) N/A

stages of change (5 categories: 

pre-contemplation, contemplation, 

preparation, action, ex-smoker)

N/A

Kunik, 

200857

COPD Exercise tolerance 6MWT N/A 18

Quality of life BAI anxiety

BDI-II depressive symptoms

CRQ Qol: fatigue

Qol: mastery

Qol: dyspnoea

Qol: emotion

SF-36 emotional composite

general health

mental health

pain

physical composite

physical function

role-emotionally

role-physical

social function

vitality

Utilization use of health services N/A

Bestall, 

200354

COPD Anxiety/Depression HADS anxiety 12

depression

Exercise tolerance shuttle walking

walking distance

Quality of life CRDQ (7-pt Likert scale) emotional function

fatigue

mastery

dyspnoea

SGRQ health status: activity

health status: impacts

health status: 

symptoms

Self-efficacy EADL N/A
86

Group Visits Focusing on Education for the Management

of Chronic Conditions in Adults Evidence-based Synthesis Program

Study Clinical 

area Category Outcomes/Measures Subscale

Total 

outcomes 

examined

DoneskyCuenco, 

2009102

COPD Biophysical FEVI/FVC N/A 16

Quality of life SF-36 mental component

physical component

Quality of life/

Functional status or 

disability

FPI total functional 

performance

Self-efficacy CRQ mastery 

Anxiety SSAI N/A

Anxiety/Depression CESD N/A

Exercise tolerance incremental cycle (ergometry) N/A

hamstring flex tq/bw 180 N/A

hamstring flexion tq/bw 90 N/A

quads extension tq/bw 180 N/A

quads extension tq/bw 90 N/A

Fatigue CRQ fatigue

Quality of life CRQ emotional 

CRQ (Borg) dyspnea N/A

FEVI (lung function) N/A

Effing, 

201155

COPD Anxiety/Depression HADS anxiety 14

depression

Biophysical FFM N/A

Exercise tolerance CRQ dyspnoea 

ESWT distance

ISWT distance

max exercise capacity N/A

steps per day (pedometer) N/A

Fatigue CRQ fatigue

Quality of life CCQ functional state

mental state

symptoms

emotional function

Self-efficacy CRQ mastery

Ninot, 201156 COPD Exercise tolerance 6MWD N/A 16

daily physical activity (Voorrips) N/A

Quality of life HRQoL N/A

SGRQ health status: impacts

health status: 

symptoms

health status: total

health status: activity

utilization N/A

VAS dyspnea

NHP physical mobility

pulmonary function N/A

Quality of life/Pain NHP pain

sleep 

energy

social isolation

emotional reaction
87

Group Visits Focusing on Education for the Management

of Chronic Conditions in Adults Evidence-based Synthesis Program

Study Clinical 

area Category Outcomes/Measures Subscale

Total 

outcomes 

examined

Fu, 200390 COPD, 

multiple 

morbidity

Fatigue fatigue N/A 13

Functional status or 

disability

disability N/A

Health behavior aerobic exercise N/A

Health status depression N/A

health distress N/A

pain N/A

self-rated health N/A

shortness of breath N/A

social and role activity limitations N/A

Self-management cognitive symptom management N/A

Self-efficacy Self-efficacy in self-management managing symptoms

managing disease in 

general

Utilization hospital stays N/A

Dejesus, 

200977

Diabetes Biophysical DBP N/A 3

SBP N/A

Utilization # of MD and RN visits N/A

Elzen, 200789 Diabetes, 

multiple 

morbidity

Exercise tolerance self-management behavior: frequency of 

exercise 

N/A 12

Quality of life RAND-36 general health

physical functioning

role limitations 

(physical problem)

physical component: 

pain

mental health

role limitations 

(emotional problem)

social functioning

vitality

Self-efficacy GSES-16 self-efficacy 

self-management behavior: cognitive 

symptom mgmt

N/A

Utilization communication with physician N/A

Lorig, 200391 Diabetes, 

multiple 

morbidity

Anxiety/Depression health status: health distress N/A 13

Exercise tolerance behavior: exercise (total min per week) N/A

Fatigue health status: fatigue N/A

Functional status or 

disability

health status: role function N/A

Health status health status: self-reported health N/A

Pain health status: pain? N/A

Self-efficacy behavior: current use tobacco N/A

behavior: mental stress mgmt N/A

self-efficacy (4-item scale) N/A

Utilization communication with physician (4-item 

scale)

N/A

ER visits N/A

hospital days N/A

physician visits N/A
88

Group Visits Focusing on Education for the Management

of Chronic Conditions in Adults Evidence-based Synthesis Program

Study Clinical 

area Category Outcomes/Measures Subscale

Total 

outcomes 

examined

Weinger, 

201114

Diabetes Anxiety/Depression Depression (Brief Symptom 

Inventory-18)

N/A 12

diabetes-related distress (5-point Likert 

scale)

N/A

Biophysical BMI N/A

HbA1c N/A

HDL cholesterol N/A

LDL cholesterol N/A

Exercise tolerance mean 3-day pedometer N/A

Quality of life diabetes (100-point scale) N/A

Self-management glucose meter checks N/A

Self-efficacy controlled coping styles N/A

self-care inventory (5-point Likert scale) N/A

self-efficacy (5-point Likert scale) N/A

Khunti, 

201268 

Diabetes Anxiety/Depression HADS N/A 27

Biophysical blood pressure N/A

BMI N/A

diastolic BP N/A

HbA1c N/A

HDL cholesterol N/A

LDL cholesterol N/A

systolic BP N/A

total cholesterol N/A

triglycerides N/A

UKPDS 10 yr CHD risk N/A

Waist circumference N/A

Health behavior physical activity N/A

smoking status N/A

Health status Problem areas in diabetes questionnaire 

(emotional distress)

N/A

Quality of life WHO QOL-BREF main scale

health satisfaction

physical QOL

psychological QOL

social QOL

environmental QOL

Self-efficacy IPQ-R perceived knowledge 

(coherence)

perceived illness 

duration (timeline)

perceived self control

perceived seriousness

perceived impact
89

Group Visits Focusing on Education for the Management

of Chronic Conditions in Adults Evidence-based Synthesis Program

Study Clinical 

area Category Outcomes/Measures Subscale

Total 

outcomes 

examined

Adolfsson, 

200775

Diabetes Biophysical BMI N/A 6

HbA1c N/A

weight N/A

Knowledge VAS scale (confidence in DM 

knowledge)

N/A

Quality of life Satisfaction with daily life (adapted 

WHO QOL)

N/A

Self-efficacy 10-item questionnaire N/A

Anderson, 

200576

Diabetes Attitudes seriousness of diabetes (Diabetes 

Attitude Scale-3)

N/A 10

Biophysical diastolic BP N/A

HbA1c N/A

serum cholesterol N/A

systolic BP N/A

weight N/A

Knowledge perceived understanding of diabetes N/A

Self-efficacy DES-SF (psychosocial self-efficacy) N/A

Social and 

psychological factors

Diabetes Care Profile (DCP) negative attitude

positive attitude

Brown, 

200516

Diabetes Biophysical FBG (fasting blood glucose) N/A 3

HbA1c N/A

Knowledge diabetes knowledge N/A

Brown, 

200215

Diabetes Biophysical BMI N/A 13

cholesterol N/A

FBG N/A

HbA1c N/A

height N/A

triglycerides N/A

weight N/A

Knowledge diabetes knowledge N/A

Self-efficacy health beliefs: barriers N/A

health beliefs: benefits N/A

health beliefs: control N/A

health beliefs: impact of job N/A

health beliefs: social support N/A

Davies, 

200870

Diabetes Biophysical BMI N/A 11

DBP N/A

HbA1c N/A

HDL N/A

LDL N/A

SBP N/A

total cholesterol N/A

triglycerides N/A

waist circumference N/A

Health behavior physical activity N/A

smoking status N/A
90

Group Visits Focusing on Education for the Management

of Chronic Conditions in Adults Evidence-based Synthesis Program

Study Clinical 

area Category Outcomes/Measures Subscale

Total 

outcomes 

examined

De Greef, 

201173

Diabetes Biophysical BMI N/A 10

FBG N/A

HbA1c N/A

tape measure cm (narrowest part of the 

torso)

N/A

total cholesterol N/A

Health behavior IPAQ (self-reported PA) min/day housekeeping 

and gardening

min/day moderate-tovigorous PA

min/day total PA

min/day walking during leisure time

steps/day

D’Eramo 

Melkus, 

201013

Diabetes Anxiety psychosocial PAID 25

Biophysical DSP N/A

HbA1c N/A

physiological FBG

weight

LDL cholesterol

HDL cholesterol

SBP N/A

TG N/A

Health behavior physiological Current smoker

Pain psychosocial pain

Psychosocial role-physical N/A

Quality of life psychosocial QOL

Self-efficacy psychosocial diabetes self-efficacy

Functional status or 

disability

physical function N/A

Health status general health N/A

vitality N/A

mental health somatic anxiety

Psychosocial social function N/A

role-emotional N/A

Support provider support diet

exercise

knowledge

support

Hornsten, 

200817

Diabetes Biophysical BMI N/A 8

DBP N/A

HbA1c N/A

HDL N/A

LDL N/A

SBP N/A

total cholesterol N/A

triglycerides N/A
91

Group Visits Focusing on Education for the Management

of Chronic Conditions in Adults Evidence-based Synthesis Program

Study Clinical 

area Category Outcomes/Measures Subscale

Total 

outcomes 

examined

Kulzer, 

200772

Diabetes Anxiety trait-anxiety symptoms N/A 16

Biophysical BMI N/A

cholesterol N/A

FBG N/A

HbA1c N/A

HDL cholesterol N/A

triglycerides N/A

weight weight

Health behavior exercise N/A

Three Factor Eating Questionnaire cognitive restraint of 

eating

hunger

inhibition

Knowledge diabetes knowledge N/A

Self-efficacy foot care N/A

negative well-being N/A

self care: urine or blood glucose self-test N/A

Lorig, 200969 Diabetes Anxiety/Depression PHQ-9 N/A 17

Biophysical HbA1c N/A

weight N/A

Health behavior aerobic exercise N/A

communication with physician N/A

glucose monitoring N/A

healthy eating N/A

read food labels N/A

Health status fatigue (VNS) N/A

self-reported global health (NHS) N/A

symptoms of hyperglycemia N/A

Self efficacy PAM N/A

diabetes self-efficacy scale N/A

Utilization days in hospital N/A

emergency visits N/A

physician visits N/A

Lujan, 200778 Diabetes Biophysical HbA1c (Bayer 2000 analyzer) N/A 3

Knowledge DKQ (diabetes knowledge) N/A

Self-efficacy DHBM (diabetes health belief) N/A

PhilisTsimikas, 

201118

Diabetes Biophysical BMI N/A 8

DBP N/A

HbA1c N/A

HDL N/A

LDL N/A

SBP N/A

total cholesterol N/A

triglycerides N/A

Raji, 200280 Diabetes Biophysical BMI N/A 2

HbA1c N/A
92

Group Visits Focusing on Education for the Management

of Chronic Conditions in Adults Evidence-based Synthesis Program

Study Clinical 

area Category Outcomes/Measures Subscale

Total 

outcomes 

examined

Rickheim, 

200274

Diabetes Attitudes ATT-19 (psychosocial adjustment and 

attitudes towards diabetes)

N/A 10

Biophysical BMI N/A

HbA1c N/A

weight N/A

Health behavior exercise duration N/A

exercise frequency N/A

Knowledge knowledge N/A

Quality of life SF-36 mental health

physical health

Self-efficacy goal achieved N/A

Rosal, 201119 Diabetes Biophysical BMI N/A 19

DBP N/A

HbA1c N/A

HDL cholesterol N/A

LDL cholesterol N/A

SBP N/A

triglycerides N/A

waist circumference N/A

Health behavior Alternative healthy eating index N/A

sitting N/A

total kcal % fat

% SFA

% carbohydrates

total physical activity N/A

duration

walking N/A

Health status Diabetes medication intensity score N/A

Knowledge Audit of Diabetes Knowledge N/A

Self-efficacy Study specific scale diet and physical 

activity change
93

Group Visits Focusing on Education for the Management

of Chronic Conditions in Adults Evidence-based Synthesis Program

Study Clinical 

area Category Outcomes/Measures Subscale

Total 

outcomes 

examined

Rygg, 201221 Diabetes Biophysical BMI N/A 22

Creatinine N/A

DBP N/A

HbA1c N/A

HDL N/A

SBP N/A

total cholesterol N/A

triglycerides N/A

weight N/A

Knowledge diabetes knowledge test N/A

Psychosocial PAID - problem areas in diabetes N/A

Quality of life EQ-5D (VAS) N/A

SF-36 physical

mental health

Self-efficacy PAM N/A

Self-management avoidance fatty foods N/A

blood glucose monitoring N/A

foot care N/A

high vegetable intake N/A

Treatment satisfaction DTSQ N/A

Utilization medication (oral glucose lowering 

agents/insulin)

N/A

Utilization N/A

Sarkadi, 

200481

Diabetes Biophysical BMI N/A 2

HbA1c N/A

Scain, 200982 Diabetes Biophysical BMI N/A 10

DBP N/A

FBG N/A

HbA1c N/A

HDL cholesterol N/A

SBP N/A

total cholesterol N/A

triglycerides N/A

waist-hip ratio N/A

Knowledge knowledge N/A

Schillinger, 

200930

Diabetes Biophysical BMI N/A 14

DBP

HbA1c NA

SBP

Functional status or 

disability

bed days N/A

restricted activity N/A

Health behavior moderate physical activity N/A

vigorous exercise N/A

Quality of life SF-12 physical health

mental health

Self-efficacy behavioral self-management

DQIP (diabetes self-efficacy) NA

interpersonal processes of care summary scale

Treatment satisfaction patient assessment of chronic illness care summary scale
94

Group Visits Focusing on Education for the Management

of Chronic Conditions in Adults Evidence-based Synthesis Program

Study Clinical 

area Category Outcomes/Measures Subscale

Total 

outcomes 

examined

Sharifirad, 

201283

Diabetes Biophysical BMI N/A 9

DBP N/A

HbA1C N/A

HDL - cholesterol N/A

LDL - cholesterol N/A

SBP N/A

triglycerides N/A

weight N/A

WHR N/A

Sperl-Hillen, 

201184

Diabetes Anxiety/Depression PAID (diabetes distress) N/A 17

Quality of life SF-12 mental health

physical health

Biophysical DBP N/A

HbA1c N/A

SBP N/A

weight N/A

Health behavior BRFSS physical activity score

Self-efficacy RFS (food summary score) N/A

DCP care ability

importance of care

negative attitude

positive attitude

support attitudes

support received

understanding

DES-SF N/A

Steed, 200585 Diabetes Biophysical HbA1c N/A 20

Health beliefs beliefs seriousness

treatment 

effectiveness

personal control

Knowledge Knowledge N/A

Mental health HADS mood

PANAS negative affect

positive affect

Quality of life ADDQOL N/A

SF-36 N/A

Self-efficacy MDS: multidimensional diabetes scale total

diet

HBGM

exercise

Self-management Revised summary of self care diabetes 

activities measure

N/A

diet

HBGM

foot care

smoking 
95

Group Visits Focusing on Education for the Management

of Chronic Conditions in Adults Evidence-based Synthesis Program

Study Clinical 

area Category Outcomes/Measures Subscale

Total 

outcomes 

examined

Toobert, 

201186

Diabetes Biophysical HbA1c N/A 12

Health behavior % calories saturated fat N/A

Chronic illness resources survey total 

score

N/A

physical activity (IPAQ) N/A

smoking prevalence N/A

stress management daily practice N/A

Health status UKPDS CHD N/A

Problem solving 

ability

diabetes problem solving interview N/A

Quality of life CDC Healthy Days measure physical health

mental health

Self-efficacy COCSC N/A

Social support UCLA social support inventory N/A

Toobert, 

201187

Diabetes Biophysical HbA1c N/A 10

Health behavior Chronic illness resources survey total 

score

N/A

stress management daily practice N/A

% calories saturated fat N/A

Physical activity (IPAQ) N/A

Health status UKPDS CHD N/A

Problem solving 

ability

diabetes problem solving interview N/A

Self-efficacy COCSC N/A

Biophysical BMI N/A

Social support UCLA social support inventory N/A

Zapotozky, 

200188

Diabetes Biophysical Cholesterol N/A 7

DBP N/A

HbA1c N/A

HDL cholesterol N/A

LDL cholesterol N/A

SBP N/A

triglycerides N/A

Surwit, 

200220

Diabetes Anxiety STAI trait 8

state

Anxiety/Depression PSS N/A

Biophysical BMI N/A

HbA1c N/A

Health behavior Dietary intake N/A

Health status DASI N/A

GHQ N/A

Miller, 

200279 

Diabetes Biophysical Fasting plasma glucose N/A 6

HbA1c N/A

HDL cholesterol N/A

LDL cholesterol N/A

total cholesterol N/A

triglycerides N/A
96

Group Visits Focusing on Education for the Management

of Chronic Conditions in Adults Evidence-based Synthesis Program

Study Clinical 

area Category Outcomes/Measures Subscale

Total 

outcomes 

examined

Smeulders, 

2009103 and 

201027,60

Heart 

failure

Anxiety/Depression HADS anxiety 21

depression

Quality of life RAND-36 and KCCQ C-Qol sum score

RAND-36 G-QoL mental

G-QoL physical

KCCQ (cardiac-specific) N/A

Self-efficacy cognitive symptom management (Lorig 

et al. 1996)

N/A

EHFScBS self-care behavior

perceived control (mastery scale by 

Pearlin and Schooler 1978)

N/A

VAS perceived autonomy

GSES general self-efficacy

two sub-scales CSEQ cardiac self-efficacy

health behavior: drinking N/A

health behavior: smoking N/A

Functional status or 

disability

TICS (cognitive status) N/A

Biophysical BMI N/A

Exercise tolerance bicycling N/A

other N/A

swimming N/A

walking N/A

Utilization number of MD and RN contacts N/A

Andryukhin, 

2010104

Heart 

failure

Anxiety/Depression HADS anxiety 16

depression

Biophysical blood glucose N/A

BMI N/A

CRP N/A

LASI N/A

LDL N/A

LVDVI N/A

LVMI N/A

NT-proBNP N/A

total cholesterol N/A

Exercise tolerance 6MWT N/A

waist circumference N/A

Quality of life MLHFQ emotional health

physical health

total level

Chang, 

200559

Heart 

failure

Exercise tolerance VO2max N/A 5

Quality of life MLwHF emotional health

physical health

peace and faith N/A

strength (spiritual) N/A
97

Group Visits Focusing on Education for the Management

of Chronic Conditions in Adults Evidence-based Synthesis Program

Study Clinical 

area Category Outcomes/Measures Subscale

Total 

outcomes 

examined

Moore, 

200658

Heart 

failure

Anxiety/Depression Depression/Dejection Scale N/A 18

Exercise tolerance exercise amount N/A

exercise frequency N/A

exercise maintenance N/A

6MWT N/A

Functional status or 

disability

cardiac functional status N/A

NYHA (cardiac functional status) N/A

Pain pain N/A

Self-efficacy benefits barriers: benefits N/A

benefits barriers: barriers N/A

benefits barriers: total N/A

problem-solving inventory N/A

total problem solving N/A

self-efficacy: barriers N/A

ASES (adherence) N/A

ISR N/A

SSES - social support friends

family

Nessman, 

198062

HypertensionSelf-efficacy attendance N/A 5

pill count N/A

test questions N/A

Utilization communications N/A

Biophysical blood pressure N/A

Rujiwatthanakorn, 

201163

HypertensionBiophysical BP diastolic N/A 9

BP systolic (Mate) (oscillometrics) N/A

Exercise tolerance SCABPCQ self-care ability: aerobic exercise

Self-efficacy KSCDQ knowledge of self-care

SCABPCQ - self-care ability dietary control

medication taking

risk behavior 

avoidance

self-monitoring

stress mgmt

Baghianimoghadam, 

201067

HypertensionSelf-efficacy Beliefs, Attitude, Subjective Norms, 

Enabling Factors (BASNEF) model 

Attitude 5

Subjective norms

Intention

Enabling factors

Self-monitoring
98

Group Visits Focusing on Education for the Management

of Chronic Conditions in Adults Evidence-based Synthesis Program

Study Clinical 

area Category Outcomes/Measures Subscale

Total 

outcomes 

examined

Balcazar, 

200964

HypertensionAnxiety acculturative stress N/A 14

stress due to migration N/A

Biophysical BMI N/A

waist circumference (inches) N/A

Self-efficacy family cohesiveness N/A

Glindex score/acculturation N/A

cholesterol and fat healthy habits N/A

perceived barriers N/A

perceived benefits N/A

perceived severity N/A

perceived susceptibility N/A

salt and sodium healthy habits N/A

self-efficacy N/A

weight control healthy habits N/A

Burke, 

2008105

HypertensionBiophysical blood lipids N/A 26

BMI N/A

BP ambulatory N/A

diastolic BP N/A

glucose N/A

HDL cholesterol N/A

HOMA-IR (insulin) N/A

insulin N/A

systolic BP N/A

total cholesterol N/A

triglycerides N/A

Exercise tolerance physical activity N/A

Self-efficacy alcohol intake N/A

calcium N/A

diet N/A

energy N/A

fiber N/A

magnesium N/A

mono fat N/A

poly fat N/A

potassium N/A

protein N/A

sat fat intake N/A

sodium N/A

total fat N/A
99

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of Chronic Conditions in Adults Evidence-based Synthesis Program

Study Clinical 

area Category Outcomes/Measures Subscale

Total 

outcomes 

examined

Figar, 200665 Hypertension

Biophysical ABPM day-time diastolic BP 11

diastolic BP at program office

night-time diastolic 

BP

total diastolic BP

change in systolic BP N/A

day-time systolic BP (6am-8pm) N/A

night-time systolic BP (8:01 pm- 5:59am) N/A

potassium excretion N/A

sodium excretion N/A

systolic BP at program office N/A

total systolic BP N/A

Pierce, 

1984106

HypertensionBiophysical BP reduction diastolic N/A 6

BP reduction systolic N/A

Health status clinician assessment medication strength 

clinician assessment BP severity

Self-efficacy daily monitoring N/A

health education N/A

Scala, 200866 Hypertension

Biophysical DBP N/A 7

SBP N/A

Exercise tolerance daily physical activity N/A

Self-efficacy drug/alcohol/consumption N/A

quantity of natural water consumption N/A

salt intake N/A

weight control N/A

Svetkey, 

200926

HypertensionBiophysical change in DBP N/A 10

change in SBP N/A

FBG and lipids N/A

urinary sodium N/A

weight N/A

Exercise tolerance physical activity N/A

Self-efficacy dairy (servings/day) N/A

dietary pattern N/A

sat fat N/A

total fat N/A

Clemson, 

200424

History of 

falls

Anxiety Worry scale N/A 7

Functional status or 

disability

PASE (physical activity) N/A

Quality of life SF-36 mental health

physical health

Self-efficacy mobility efficacy scale (MES) falls

modified falls efficacy scale (MFES) falls

FaB scale (behaviors fall prevention) N/A
100

Group Visits Focusing on Education for the Management

of Chronic Conditions in Adults Evidence-based Synthesis Program

Study Clinical 

area Category Outcomes/Measures Subscale

Total 

outcomes 

examined

Arnold, 

2008107

History of 

falls

Falls falls-efficacy N/A 9

Physical performance (hip abduction strength) N/A

6MWT (gait) N/A

BBSm (balance) N/A

lower body strength N/A

max step length N/A

MCTSIB (balance function) N/A

ROM (hip flexion range of motion) N/A

TUG (mobility) N/A

ShumwayCook, 200725

History of 

falls

Falls fall incidence rates N/A 4

Functional status or 

disability

mobility N/A

Physical performance balance N/A

strength N/A

Arnold, 

201045

History of 

falls

Falls efficacy ABC (balance) N/A 7

Functional status or 

disability

AIMS-2 (daily function) N/A

PASE (physical activity) N/A

Physical performance 6MWT N/A

BBS (balance) N/A

chair stands N/A

TUG (mobility) N/A

Ryan, 199646 History of 

falls

Falls N fall events including descriptions N/A 3

N fall prevention changes implemented N/A

type of fall prevention changes made N/A

Ersek, 200397 Pain Anxiety/Depression GDS N/A 8

Functional status or 

disability

SF-36 physical functioning 

role-physical 

Pain GCPS pain intensity

related activity 

interference

SOPA pain-related beliefsSOPA control 

pain-related beliefsSOPA harm

pain-related beliefsSOPA medical care

Vlaeyen, 

199696

Pain Anxiety FSS-III-R (fear) N/A 12

PCL, CSQ (catastrophizing) N/A

Anxiety/Depression BDI N/A

Health status MOCI (obsessive-compulsive) N/A

Pain BAT (activity) N/A

CSQ relaxation

pain coping

CSQ, MPLC pain control

MPQ (pain intensity) N/A

UAB, CHIP, BAT (pain behavior) N/A

Quality of life/Pain tension N/A

Self-efficacy knowledge N/A
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of Chronic Conditions in Adults Evidence-based Synthesis Program

Study Clinical 

area Category Outcomes/Measures Subscale

Total 

outcomes 

examined

Gustavsson, 

201098

Pain Anxiety CSQ catastrophizing 14

FABQ fear (work place) N/A

HADS anxiety

Anxiety/Depression HADS depression

Functional status or 

disability

NDI (neck disability) N/A

Pain NDI (analgesics due to neck pain) N/A

VAS average (pain scale)

present (pain scale)

worst (pain scale)

Self-efficacy CSQ ability to control pain 

ability to reduce pain 

N/A

SES N/A

Utilization satisfaction with care/treatment (5-pt 

scale)

N/A

Haugli, 

200395

Pain Anxiety/Depression General Health Questionnaire (GHQ) psychological distress 4

Health status GHQ group status

sick leave

days absent due to pain (last 6 mo) N/A

Pain VAS pain 

pain coping

Self-efficacy VAS management of daily 

life
102

tion for the Management

Evidence-based Synthesis Program

eer review comments and responses

Response

nd methods for this review clearly described?

Noted.Noted.Noted.Noted.

f contents. Objectives are listed in the Executive Summary under the 

ion.

Noted.Noted.

eally enough evidence but perhaps a weakness is that the groups run by 

als could not be separated 

Noted.Noted.

y inclusive Noted.

Noted.

bias in our synthesis of the evidence? 

bias. Noted.

Noted.Noted.Noted.

iew utilized a variety of databases to obtain a large number of articles 

s. Some of the studies looked at were done within the VA but in my 

did not provide any type of bias.

Noted.Noted.Noted.Noted.Noted.Noted.

nd methods for this review clearly described?

f overlooked data sources. Noted.

Noted.
103

tion for the Management

Evidence-based Synthesis Program

Response

us has been intervention on blood pressure control in the group session, so 

mentioned below have a slant towards treating hypertension.

gne,C.M., Harsha, D.W., Cooper, L.S., Obarzanek, E., Elmer, P.J., Stevens, 

etkey, L.P., Stedman, S.W., Young, D.R., and Writing Group of the Premier 

ch Group. 2003. Effects of comprehensive lifestyle modification on blood 

n results of the Premier clinical trial. JAMA. 289:2083-2093

 M.H., Rahaee, Z., Morowatisharifabad, M.A., Sharifirad, G., Andishmand, 

L. 2010. Effects of education on self monitoring of blood pressure based on 

ypertensive patients. J RES MED SCI. 15:70-77

R. 2006. Randomized controlled trial on lifestyle modification in 

...including commentary by: Clark AM and response by Pinar and Cakir. 

190-215

palo, S., Holm, P., Makinen, E., and Malminiem, L. 2002 Effects of 

ucation on the resistance of LDL against oxidation and risk factors for 

se in bypass surgery patients. ANN.Med. 34:272-283

i, O., Fasoi, G., Stylianou, M., Kavga, A., Economou, O., Mandi, P., and 

The influence of the hypertensive patient’s education in compliance with 

blic Health Nurs. 18:436-442

Two of the suggested papers (Cakir, Saounatsu) were a combination of group and individual visits, and it was impossible to separate out the effects of these respective intervention components. We examined the Palomaki study and decided against including it because the study design was not a randomized controlled trial.We agree that the Baghianimoghadam study should be included, which we have done, and have amended our results accordingly. We cited the Appel paper in the Limitation section as an example of a good quality study that combined group and individual visits without analyzing the group visit component separately, and clarified that we did not include these studies.Noted.

are of. Noted.

Noted.

al (2012) Group diabetes education administered through telemedicine: 

ns learned. Telemedicine and EHealth, 18, p347. 

We examined the suggested study and decided against including it because the study design was not a randomized controlled trial.

aware Noted.

d at the shared medical appointment esp or the realist review of evidence 

medical appointments

We thank the reviewer for the suggestion. Yes, we have examined the shared medical appointment (SMA) ESP report and have noted that these reports are complementary reviews of group appointments. In addition, we developed our library in collaboration with the SMA group to ensure that there was no overlap in the included literature.Noted.
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tion for the Management

Evidence-based Synthesis Program

Response

ggestions or comments below. If applicable, please indicate the page and line numbers from the draft report.

e-examples given of “non-prescribing providers only include “nurses and 

hough other disciplines are listed later, expanding the variety of disciplines 

more clearly show that it is not just a nurse-run group visit. 

We have expanded the list of examples given on pg. 10, per the reviewer’s suggestion.

ppointed that the great majority of studies fail to show a preponderance of 

acy of the group medical experience versus standard treatment options in 

 in the short-term. It appears that many studies showed some improvement 

h as blood pressure readings or a reduction in LDL numbers, but not 

for long-term gains in overall physical health. It doesn’t appear that there 

one in a longitudinal fashion that would lend themselves to basing any 

erm gains. Being someone who believes in the group experience for 

continuing to use them in the form of drop in group medical appointments, 

pointments under a heading of hypertension or diabetes, I was hoping for 

would point to increasing the use of these types of clinic experiences.

We thank the reviewer for the thoughtful comments. We agree that there is a need for trials that evaluate outcomes over longer periods of time, and the utility of booster sessions. We have noted these gaps in the evidence base in the Future Research section.

ell written, including the Generalizability and Limitations sections. 

e, remove “the”, ...to attend a multi-week course”...

We thank the reviewer for the feedback on the readability of the report, and have made the suggested change.

n page 10 (Introduction Section), the report states, “This review . . .focuses 

ure that tests the effectiveness of group visits that have an emphasis 

and are led by non-prescribing providers such as nurses and nurse understanding that the intent of the report is to review studies in which 

ed by non-prescribing health professionals (e.g., nurses, dietitians). Given 

dies described in the “Multiple Chronic Conditions” section (page 59) be 

w since all but the Elzen (2007) study were led by peer leaders and not 

nals? 

We have included trials of group visits led by peer educators as well as social workers, and believe this is an important aspect to many group visit interventions that ought to be represented in the report. As a complement to the shared medical appointment report, this review was intended to expand the purview of group appointment interventions to include those led by personnel that are non-physicians.We have clarified that we include group visit facilitators that exclude prescribing providers and may include health professionals (e.g., nurses, dietitians, physical therapists). 

d report on Shared Medical Appointments included a table in the “Future 

at identified evidence gaps and suggested types of studies to close those 

ssible to include a similar table in this report?

Yes, we agree that the Future Research section in table form, similar to the one used in the shared medical appointments report, is a useful way to display gaps in the research done in this area. We have made this change.
105

tion for the Management

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Response

ontribution. I hope that in the discussion that you may add that areas that 

nefit but the studies are not strong, may be areas for further pilot testing 

e data collecting. I don’t personally believe that the only answer is more 

more practice with the evidence we have. Patients’ self efficacy and 

onic disease care is critical for VA in the future when veterans can choose 

healthcare. Low cost options that may improve even short term outcomes 

ng in, especially when led by peers and in the community. I don’t want to 

of clinical care. Happy to talk further. Would be happy to be involved in 

t this and comparing to sma ESP and sma realist review. 

We thank the reviewer for the thoughtful comments. We have added suggestions for further pilot testing in the field and more efforts for data collection to the Future Research section.

 modifications.

up Visits Draft: Use of “dietitian” on pages 12, 47, 49, 86 – please spell 

ad of a “c” in dietician 

ity section, last sentence- p. , suggest use of terminology “who demonstrated

tead of “who have enough motivation” which appears vague

71- “Knowledge improvement outcomes” instead of “knowledge outcomes” 

dge was not studied, the use of knowledge does not indicate any qualitative 

changes

Noted. We have made these changes.

erformance measures, programs, quality improvement measures, patient care services, or conferences that will be directly 

o, please provide detail.

 care clinical performance is evaluated on percentage of encounters that 

ting, including educational and self management groups offered by nursing 

ect this will impact what conditions are treated in this fashion, with self

ed over didactic methods. 

Noted.

eport but this report in conjunction with the SMA report from Durham may 

MAs in PACT. Could influence targets in Compass related to non-single 

 visits in PACT. 

Noted.

ly a “push” within the VA for expansion of the use of group medical 

ared medical appointments. Some of the focus in PACT (Patient Aligned 

he VA is the use by the care team in fashioning unique and “out of the 

he usual one patient-one provider-one visit model. There has also been a idence based practice measures to our daily practice in hopes of improving 

will have to continue to look at group medical experiences, and the 

able to determine how much emphasis is placed on the utilization of these 

s, as well as looking at the long term effects of these types of encounters to 

benefit.

Noted.
106

tion for the Management

Evidence-based Synthesis Program

Response

d under Access in the 2012 Compass Goals for VISN 12. Currently, groups 

etes, lipids, CHF, and weight management. To meet access goals, groups 

to be seen in a timely manner. Individual appointment are also available, 

sive. 

Noted.Noted.

menting group education to meet performance measures for DM Noted.

prioritized group visits as part of the new primary care model, staff who 

T teams will be directly affected by this report. There are currently VA 

es are involved in group visits. In the next couple of weeks, the Office of 

rough the ONS liaisons to PACT and Specialty Care, will attempt to obtain 

 currently conduct group visits along with the target population for those 

onal Diabetes Program, the national Pain Program, and the National Center 

lls) would likely be interested in this report.

Noted.

T and NCP. We can disseminate findings through them at a national level. 

nd Margaret Dundon. 

Noted.

mendations on how this report can be revised to more directly address or assist implementation needs.

 have data about what VA’s are currently offering in relation to these conditions. We agree that it would be helpful to discuss 

implementation of group visits and shared medical appointments within the context of what the VA currently offers for Veterans with chronic conditions. Although these considerations are important, this discussion this extends beyond the scope of this review.

o not only know whether group visits affects the usage/frequency of 

whether the traditional visit is altered when patients also attend group visits. 

ocus of the single provider face-to-face visit changed when patients also 

e. patients that attend pain SMAs may still see their provider on the same 

ay be able to address more issues unrelated to pain whereas in the past the 

focused on pain-related issues). 

This is a very interesting point. It would be an interesting premise for additional qualitative studies examining the quality of care provided in GVs as a complement to traditional individual clinical visits. We included studies of comparative effectiveness of head-to-head individual visits versus group visits. Unfortunately, there were few of these studies and we have identified this as a gap in the research base in the Future Research section. 
107

tion for the Management

Evidence-based Synthesis Program

Response

 does not seem to be saying that there is not benefit to the group 

oes seem to point to the issue of perhaps longer studies being necessary. 

perceives benefit from a group experience whether the data seems to show 

efit “is a much more nebulous and decidedly more difficult factor to 

l have to be prudent in using group experiences so that the focus continues 

arch to guide implementation of these appointments versus using these 

cerns.

We agree with the reviewer and have made these points in the Future Research and Discussion sections.

 Medicare reimbursement have been the driving forces for group education 

In the VA, however, group education has been a means to improving better 

terans in a timely manner. I am curious to know if length of class time (60, 

ber of group visits(3-12 sessions) negatively influenced the group findings 

uestions? Individual visits might have been shorter (30-60 minutes) and 

visits. Ultimately giving patients a choice in how they receive education—

—is patient centric. A synthesized review showing that the results appear to 

hey receive individual or group education seem to support this new health 

ould encourage more research in the area of secured messaging and how 

y might affect patient outcomes in the management of chronic diseases. 

ge research in the area of MOVE! Groups and how they compare to 

We abstracted length and duration of group visits in the expectation that we would be able to compare trials based on these important elements. However, heterogeneity between trials was significant and precluded examination of these important questions. We agree that further research is needed and have identified various gaps in the Future Research section that the reviewer also identifies.

 concern is that somewhat positive findings from RCTs of group 

ot necessarily translate into improved outcomes in real life situation, given 

erent to characteristics of research participants in general (usually more 

rned about their health). I just read a study from Netherlands that looked 

preferences for educational programs on falls and found that the majority 

est to participate in any format; in addition, poor perceived health and age 

ted with less preference for a group program format. (Dorresteijn, TA, 

n Eijs YJ, Vlaeyen JW, Kempen GI. Older people’s preferences regarding 

for managing concerns about falls. Age Aging . 2012;41(4):474-81). 

he weak evidence and the heterogeneity of intervention content and 

mentation of group appointments, especially in Geri PACTs, should not 

aving to come in for a group appointment may not be the “most patient 

frail older individual. Also, additional evaluations should be incorporated 

A implementation effort, so that meaningful conclusions could be made in 

ue of group appointments in the VA. 

The reviewer brings up some very important and interesting considerations. Although we did not find any direct harms, the VA should be cautious given the lack of robust findings that GV improve health outcomes. In addition, there is potential for downsides to GV implementation. For example, travel time involved to get to and participate in GVs, which as the reviewer points out, may be a salient and prohibitive factor for frail, older participants. Given the relatively low benefits in health outcomes and the risk of inconvenience, we need to be careful about making blanket recommendations of group visits, particularly for patient populations with specific health needs. We have included these points in the Discussion section.

 or community of practice Noted.
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tion for the Management

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Response

tact details of any additional individuals/stakeholders who should be made aware of this report.

hip, Mental Health leadership Noted.

Watts Noted.

Noted.

care clinical teams will benefit HRSD should be aware of this as there is a 

Noted.

program knows the date of the CyberSeminar when this report will be 

please send this information to Bev Priefer in the Office of Nursing Services 

me advance notification of the various nursing groups that will be interested 

Noted.

an, me, dr kinsinger, dr Goldstein, ONS, Anthony morreale in 

Noted.

ers include Primary Care Leaders to share with PACT teamlets and teams, 

nators. The PACT and ACCESS goals promote the use of group education 

seases. Additionally, individual visits are still available, offering Veteran’s 

Noted.
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Group Visits Focusing on Education for the Management

of Chronic Conditions in Adults Evidence-based Synthesis Program

APPENDIX E. Glossary for outcomes used in

included studies

Acronym Measure/Outcome

28 JC 28 Joint Count

AAMP Australian Asthma Management Plan

AASA Asthma Attitude Survey for Adults (24-item)

ABC Activities-specific Balance Confidence

ABPM Ambulatory Blood Pressure Monitoring

ADAPT Arthritis, diet and physical activity promotion trial

ADDQOL Audit of Diabetes-Dependent Quality of Life

AGKQ Asthma General Knowledge Questionnaire

AHI Arthritis Helplessness Index

AIMS2/Dutch-AIMS2 Arthritis Impact Measurement Scales version 2

AIMS2: AS Arthritis Impact Measurement Scales version 2: Affect Subscale

AIMS2: CHS Arthritis Impact Measurement Scales version 2: Current Health Subscale

AIMS2: PFS Arthritis Impact Measurement Scales version 2: Physical Function Subscale 

AIMS2: SS Arthritis Impact Measurement Scales version 2: Symptom Subscale

ANCOVA Analysis of Covariance

AQLQ Asthma Quality of Life Questionnaire

AQOL Assessment of Quality of Life

ASCQ Arthritis Stages of Change

ASES Asthma or Arthritis Self-efficacy Scale

ASMP Arthritis Self-Management Program

BAI Beck Anxiety Inventory

BASNEF Belief, Attitude, Subjective Norm, Enabling Factors educational model

BAT Behavioral Approach Test

BDI and BDI-II Beck Depression Inventory

BIQ Basic Information Quiz (51-item)

BMI Body Mass Index

BRFSS Behavioral Risk Factor Surveillance System

CBT Cognitive Behavioral Therapy

CCQ Clinical COPD Questionnaire

CES-D Center for Epidemiologic Studies Depression Scale

CHANGE Change Habits by Applying New Goals and Experiences

CHIP Checklist for Interpersonal Pain Behavior

COCSC Confidence in Overcoming Challenges to Self-Care instrument

COPE Community-based physiotherapeutic exercise program

CORS Coping With Rheumatoid Stressors

CQ Asthma Knowledge Questionnaire (12-item)

CRDQ (aka CRQ) Chronic Respiratory Disease Questionnaire

CRQ-SAS Chronic Respiratory Questionnaire Standardised
110

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of Chronic Conditions in Adults Evidence-based Synthesis Program

Acronym Measure/Outcome

CSEQ Cardiac Self-efficacy Questionnaire (two sub-scales)

DAS28 Disease Activity Score using 28 joint counts

DASI Duke Activity Status Index

DCP Diabetes Care Profile

DES-SF Diabetes Empowerment Scale, Short Form

DHBM Diabetes Health Belief Measure

DKQ Diabetes Knowledge Questionnaire

DQIP Diabetes Quality Improvement Program

DSMP Diabetes Self-management Program

DTSQ Diabetes Treatment Satisfaction Questionnaire

EADL Extended Activities of Daily Living

EMIR French Quality of Life of RA (using short version of AIMS2-SF)

EMS Early Morning Joint Stiffness

EQ-5D: VAS Five Dimensional Health State Description of EuroQol

ESR Erythrocyte Sedimentation Rate

ESWT Endurance Shuttle Walk Test

EURIDISS EUropean Research on Incapacitating Diseases and Social Support

EuroQol Euro Quality of Life

FaB scale Falls Behavioural Scale (behaviors protective of falls)

FABQ Fear Avoidance Belief Questionnaire

FACIT-F Functional Assessment of Chronic Illness Therapy-Fatigue

FAST Fitness Arthritis and Senior Trial

FBG Fasting Blood Glucose

FEV Forced Expiratory Volume

FFM Percentage of Fat Free Mass

FIT Educational and physical training program

FPI Functional Performance Inventory

FSS-III-R Distinguishes 5 types of fears/phobias

GCPS Chronic Pain Scale

GDS Geriatric Depression Scale

GHQ General Health Questionnaire

GSES-16 General Self-Efficacy Scale

GV Group visit

HAAS Hypothetical Asthma Attack Scenarios

HADS Hospital Anxiety and Depression Scale

HAQ Health Assessment Questionnaire

heiQ Health Education Impact Questionnaire

HJAM Hand Joint Alignment and Motion Scale

HJC Hand Joint Count

HOMA-IR Homeostasis Model Assessment of Insulin Resistance
111

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of Chronic Conditions in Adults Evidence-based Synthesis Program

Acronym Measure/Outcome

HRQOL Health-related Quality of Life

HSI Heaviness of Smoking Index

IDEA Interactive Dialogue to Educate and Activate

IDEALL Improving Diabetes Efforts Across Language and Literacy

IPAQ International Physical Activity Questionnaire 

IPQ-R Revised Illness Perceptions Questionnaire

ISR Index of Self-Religion

ISWT Incremental Shuttle Walk Test

JP Joint Protection

JPBA Joint Protection Behavior Assessment 

JPKA Joint Protection Knowledge Assessment 

K10 Kessler Psychological Distress Scale

KCCQ Kansas City Cardiomyopathy Questionnaire

KSCDQ Knowledge of Self-Care Demands Questionnaire

LASI Left Atrial Size Index

LMAP Lifestyle management for arthritis programme

LVDVI LV Diastolic Volume Index

LVMI Left Ventricular Mass Index

MAF Multidimensional Assessment of Fatigue Scale

MAPT Multi-Attribute Prioritisation Tool

MARS Medication Adherence Report Scale (5-item)

mCTSIB Modified Clinical Test of Sensory Interaction on Balance

MDS Multidimensional Diabetes Scale

M-HAQ Mobility-Health Assessment Questionnaire

MLHFQ (aka MLwHF) Minnesota Living With Heart Failure

MOCI Maudsley Obsessive-Compulsive Inventory 

MOS Medical Outcomes Survey (measures of quality of life core survey)

MPLC Multidimensional Pain Locus of Control Scale

MPQ McGill Pain Questionnaire

MRC Medical Research Council

NDI Neck Disability Index

NHP Nottingham Health Profile

NT-proBNP N-terminal pro-brain natriuretic peptide

NYHA New York Heart Association Classification

OT Occupational therapist

PAID Problem Areas in Diabetes Survey 

PAM Patient Activation Measure

PANAS Positive and Negative Affect Schedule

PASE Physical Activity Scale for the Elderly

PASS Pain and stress self-management program
112

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of Chronic Conditions in Adults Evidence-based Synthesis Program

Acronym Measure/Outcome

PCL Pain Cognition List

PEF Peak Expiratory Flow

PEM Self-management empowerment education model

PIHAQ Personal Impact Health Assessment Questionnaire

PSS Perceived Stress Scale

PT Physical therapist

QALYs Stanford Health Assessment Questionnaire

QOL Quality of life

RAI: AHS Rheumatology Attitudes Index: Arthritis Helplessness Subscale

RAI: AIS Rheumatology Attitudes Index: Arthritis Internality Subscale

RAND-36 RAND 36-Item Health Survey

RAQol Rheumatoid Arthritis Quality of Life

RASE RA Self-efficacy

RFS Food Summary Score

ROM Range of Motion

SCABPCQ Self-Care Ability for Blood Pressure Control Questionnaire

SES Self-efficacy Scale

SF-12 The 12-Item Short Form Health Survey

SF-36 Short Form Health Survey

SGRQ St. George’s Respiratory Questionnaire

SMART Self-management arthritis relief therapy

SOPA Survey of Pain Attitudes

SPSMQ Short Portable Mental Status Questionnaire

SSAI State Anxiety Inventory

SSES Strengths Self-Efficacy Scale

STAI Spielberger State-Trait Anxiety Inventory

TFEQ Three Factor Eating Questionnaire

TICS Telephone Interview for Cognitive Status

TSES Total Self-efficacy Scale 

TUG Timed Up and Go

UAB Pain Behavior Scale

UCL-DSMP University College London-Diabetes Self-management Program

VAS Visual Analog Scale

VNS Visual Numeric Scale for pain (modified VAS)

VO2max Maximal Oxygen Uptake

WHOQOL-BREF World Health Organization quality of life instrument, short version

WOMAC Western Ontario and McMaster Universities Osteoarthritis