Self management interventions for type 2 diabetes in adult people with severe mental illness
- PMID: 27120555
- PMCID: PMC10201333
- DOI: 10.1002/14651858.CD011361.pub2
Self management interventions for type 2 diabetes in adult people with severe mental illness
Abstract
Background: People with severe mental illness are twice as likely to develop type 2 diabetes as those without severe mental illness. Treatment guidelines for type 2 diabetes recommend that structured education should be integrated into routine care and should be offered to all. However, for people with severe mental illness, physical health may be a low priority, and motivation to change may be limited. These additional challenges mean that the findings reported in previous systematic reviews of diabetes self management interventions may not be generalised to those with severe mental illness, and that tailored approaches to effective diabetes education may be required for this population.
Objectives: To assess the effects of diabetes self management interventions specifically tailored for people with type 2 diabetes and severe mental illness.
Search methods: We searched the Cochrane Library, MEDLINE, EMBASE, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the International Clinical Trials Registry Platform (ICTRP) Search Portal, ClinicalTrials.gov and grey literature. The date of the last search of all databases was 07 March 2016.
Selection criteria: Randomised controlled trials of diabetes self management interventions for people with type 2 diabetes and severe mental illness.
Data collection and analysis: Two review authors independently screened abstracts and full-text articles, extracted data and conducted the risk of bias assessment. We used a taxonomy of behaviour change techniques and the framework for behaviour change theory to describe the theoretical basis of the interventions and active ingredients. We used the GRADE method (Grades of Recommendation, Assessment, Development and Evaluation Working Group) to assess trials for overall quality of evidence.
Main results: We included one randomised controlled trial involving 64 participants with schizophrenia or schizoaffective disorder. The average age of participants was 54 years; participants had been living with type 2 diabetes for on average nine years, and with their psychiatric diagnosis since they were on average 28 years of age. Investigators evaluated the 24-week Diabetes Awareness and Rehabilitation Training (DART) programme in comparison with usual care plus information (UCI). Follow-up after trial completion was six months. Risk of bias was mostly unclear but was high for selective reporting. Trial authors did not report on diabetes-related complications, all-cause mortality, adverse events, health-related quality of life nor socioeconomic effects. Twelve months of data on self care behaviours as measured by total energy expenditure showed a mean of 2148 kcal for DART and 1496 kcal for UCI (52 participants; very low-quality evidence), indicating no substantial improvement. The intervention did not have a substantial effect on glycosylated haemoglobin A1c (HbA1c) at 6 or 12 months of follow-up (12-month HbA1c data 7.9% for DART vs 6.9% for UCI; 52 participants; very low-quality evidence). Researchers noted small improvements in body mass index immediately after the intervention was provided and at six months, along with improved weight post intervention. Diabetes knowledge and self efficacy improved immediately following receipt of the intervention, and knowledge also at six months. The intervention did not improve blood pressure.
Authors' conclusions: Evidence is insufficient to show whether type 2 diabetes self management interventions for people with severe mental illness are effective in improving outcomes. Researchers must conduct additional trials to establish efficacy, and to identify the active ingredients in these interventions and the people most likely to benefit from them.
Conflict of interest statement
HM: none known.
KM: none known.
MH: none known.
CF: none known.
JJ: none known.
AS: none known.
Figures
Update of
References
References to studies included in this review
McKibbin 2010 {published and unpublished data}
-
- Leutwyler HC, Wallhagen M, McKibbin C. The impact of symptomatology on response to a health promoting intervention among older adults with schizophrenia. The Diabetes Educator 2010;36(6):945‐55. - PubMed
-
- McKibbin CL, Patterson TL, Norman G, Patrick K, Jin H, Roesch S, Mudaliar S, et al. A lifestyle intervention for older schizophrenia patients with diabetes mellitus: a randomized controlled trial. Schizophrenia Research 2006;86:36‐44. - PubMed
References to studies excluded from this review
ACTRN12614000138684 {published data only}
-
- ACTRN12614000138684. Comparison of the health outcomes of patients with severe mental illness and at least one co‐morbid chronic physical health problem who attend a physical health clinic at Fremantle Mental Health Services with a similar group of patients who are managed by a general practitioner in the community. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365704 (accessed 14 April 2016).
Bogner 2010 {published data only}
Bogner 2012 {published data only}
Ell 2009 {published data only}
Gois 2009 {published data only}
-
- Gois C. IPT in physical diseases. The diabetes mellitus case. European Psychiatry 2009;24(1):S278.
Green 2015 {published data only}
Hjorth 2014 {published data only}
-
- Hjorth P, Davidsen AS, Kilian R, Pilgaard Erikson S, Jensen AOW, Sørensen HØ, et al. Improving the physical health of long‐term psychiatric inpatients. Australian & New Zealand Journal of Psychiatry 2014;48(9):861‐70. - PubMed
Huang 2002 {published data only}
-
- Huan X, Lei S, Li T, Li J, Li N, Wu S. Effect of health education and psychosocial intervention on depression in patients with type 2 diabetes. Chinese Mental Health Journal 2002;16(3):149‐51.
Huang 2004 {published data only}
-
- Huang FL, Ye JH, Huang F. Effect of mental intervention on type 2 diabetes: randomized controlled trial. Chinese Journal of Clinical Rehabilitation 2004;8(27):5795‐8.
ISRCTN13762819 {published data only}
-
- ISRCTN13762819. Managing cardiovascular risk for people with severe mental illnesses. A clinical trial in primary care (PRIMROSE). http://www.isrctn.com/ISRCTN13762819 (accessed 14 April 2016).
Katon 2004 {published data only}
-
- Katon WJ, Korff M, Lin EH, Simon G, Ludman E, Russo J, et al. The Pathways Study: a randomized trial of collaborative care in patients with diabetes and depression. Archives of General Psychiatry 2004;61(10):1042‐9. - PubMed
Katon 2006 {published data only}
-
- Katon, W, Unũtzer J, Fan MY, Willians JW Jr, Schoenbaum M, Lin EH, et al. Cost‐effectiveness and net benefit of enhanced treatment of depression for older adults with diabetes and depression. Diabetes Care 2006;29(2):265‐70. - PubMed
Katon 2008 {published data only}
Katon 2012 {published data only}
Lamers 2011 {published data only}
-
- Lamers F, Jonkers CCM, Bosma H, Knottnerus JA, Eijk JTM. Treating depression in diabetes patients: does a nurse‐administered minimal psychological intervention affect diabetes‐specific quality of life and glycaemic control? A randomized controlled trial. Journal of Advanced Nursing 2011;67(4):788‐99. - PubMed
Lustman 1998a {published data only}
-
- Lustman PJ, Freedland KE, Griffith LS, Clouse RE. Predicting response to cognitive behavior therapy of depression in type 2 diabetes. General Hospital Psychiatry 1998;20:302‐6. - PubMed
Lustman 1998b {published data only}
-
- Lustman PJ, Griffith LS, Freedland KE, Kissel SS, Clouse RA. Cognitive behavior therapy for depression in type 2 diabetes mellitus: a randomized, controlled trial. Annals of Internal Medicine 1998;129:613‐21. - PubMed
NCT00253240 {published data only}
-
- NCT00253240. Diabetes screening, risk management and disease management in a high‐risk mental health population. https://clinicaltrials.gov/ct2/show/NCT00253240 (accessed 14 April 2016).
NCT00468676 {published data only}
-
- NCT00468676. Nurse‐led case management for diabetes and cardiovascular disease patients with depression. https://clinicaltrials.gov/ct2/show/NCT00468676 (accessed 14 April 2016).
NCT00564070 {published data only}
-
- NCT00564070. CBT for adherence and depression in diabetes. https://clinicaltrials.gov/ct2/show/NCT00564070 (accessed 14 April 2016).
NCT00627029 {published data only}
-
- NCT00627029. Evaluation of programs of coordinated care and disease management. https://clinicaltrials.gov/ct2/show/NCT00627029 (accessed 14 April 2016).
NCT01098253 {published data only}
-
- NCT01098253. Integrating depression services into type 2 diabetes mellitus management. https://clinicaltrials.gov/ct2/show/NCT01098253 (accessed 14 April 2016).
NCT01106885 {published data only}
-
- NCT01106885. Effective care management of depressed diabetes patients (the Positive Steps study). https://clinicaltrials.gov/ct2/show/NCT01106885 (accessed 14 April 2016).
NCT01228032 {published data only}
-
- NCT01228032. The Health Outcomes Management and Evaluation (HOME) study. https://clinicaltrials.gov/ct2/show/NCT01228032 (accessed 14 April 2016).
NCT01890226 {published data only}
-
- NCT01890226. A mobile personal health record for behavioral health homes (mPHR). https://clinicaltrials.gov/ct2/show/NCT01890226 (accessed 14 April 2016).
NCT02027259 {published data only}
-
- NCT02027259. Behavioral activation therapy for both depression and diabetes vs. diabetes alone delivered via group visits (BA‐MEDIC). https://www.clinicaltrials.gov/ct2/show/NCT02027259 (accessed 14 April 2016).
NCT02029989 {published data only}
-
- NCT02029989. Point‐of‐care testing (POCT) detection and management of metabolic syndrome in patients with mental illness. https://clinicaltrials.gov/ct2/show/NCT02029989 (accessed 14 April 2016).
NCT02053714 {published data only}
-
- NCT02053714. Improving diabetes outcomes for persons with severe mental illness. https://clinicaltrials.gov/ct2/show/study/NCT02053714 (accessed 14 April 2016).
NCT02160639 {published data only}
-
- NCT02160639. Evaluating the impact of year long, augmented diabetes self management support. https://clinicaltrials.gov/ct2/show/NCT02160639 (accessed 14 April 2016). - PMC - PubMed
Nelson 2014 {published data only}
-
- Nelson K, Drain N, Robinson J, Kapp J, Hebert P, Taylor L, et al. Peer Support for Achieving Independence in Diabetes (Peer‐AID): design, methods and baseline characteristics of a randomized controlled trial of community health worker assisted diabetes self‐management support. Contempory Clinical Trials 2014;38:361‐9. - PMC - PubMed
Petrak 2013 {published data only}
-
- Petrak F, Herpertz S, Albus C, Hermanns N, Hiemke C, Hiller W, et al. Study protocol of the Diabetes and Depression Study (DAD): a multi‐center randomized controlled trial to compare the efficacy of a diabetes‐specific cognitive behavioral group therapy versus sertraline in patients with major depression and poorly controlled diabetes mellitus. BMC Psychiatry 2013;13:206‐20. - PMC - PubMed
Pibernick‐Okanovic 2009 {published data only}
Piette 2011a {published data only}
Piette 2011b {published data only}
Robinson 2010 {published data only}
-
- Robinson SJ, Conrad G, Gibson M, Morris C, DesLauriers C, Charlebois H, et al. Multimodal healthy lifestyle intervention for prevention and or mitigation of weight gain, diabetes and dyslipidemia in a first episode psychosis population. Early Intevention in Psychosis 2010;4(Suppl 1):73.
Safren 2014 {published data only}
Sajatovic 2011 {published data only}
Salisbury 2014 {published data only}
-
- Salisbury C. The 3D study: improving care for multimorbidity patients. http://public.ukcrn.org.uk/search/StudyDetail.aspx?StudyID=16067 (accessed 14 April 2016).
Schneider 2011 {published data only}
-
- Schneider KL, Pagoto SJ, Handschin B, Panza E, Bakke S, Liu Q, et al. Design and methods for a pilot randomized clinical trial involving exercise and behavioral activation to treat comorbid type 2 diabetes and major depressive disorder. Mental Health and Physical Activity 2011;4(14):13‐21. - PMC - PubMed
Simon 2007 {published data only}
-
- Simon GE, Katon WJ, Lin EH, Rutter C, Manning WG, Korff M, et al. Cost‐effectiveness of systematic depression treatment among people with diabetes mellitus. Archives of General Psychiatry 2007;64(1):65‐72. - PubMed
Spencer 2013 {published data only}
Stiefel 2008 {published data only}
-
- Stiefel F, Zdrojewski C, Bel Hadj F, Boffa D, Dorogi Y, So A, et al. Effects of a multifaceted psychiatric intervention targeted for the complex medically ill: a randomized controlled trial. Psychotherapy and Psychosomatics 2008;77:247‐56. - PubMed
Taveira 2011 {published data only}
-
- Taveira TH, Dooley AG, Cohen LB, Khatana SAM, Wu WC. Pharmacist‐led group medical appointments for the management of type 2 diabetes with comorbid depression in older adults. The Annals of Pharmacotherapy 2011;45:1346‐55. - PubMed
van Bastelaar 2009 {published data only}
-
- Bastelaar KMP, Pouwer F, Cuijpers P, Snoek FJ. Web‐based cognitive behavioural therapy for diabetes patients with comorbid depression: first findings. Diabetologia 2009;52(Suppl 1):S393.
van Bastelaar 2011a {published data only}
-
- Bastelaar K, Cuijpers P, Pouwer F, Riper H, Snoek FJ. Development and reach of a web‐based cognitive behavioural therapy programme to reduce symptoms of depression and diabetes‐specific distress. Patient Education and Counselling 2011;84:49‐55. - PubMed
van Bastelaar 2011b {published data only}
van Bastelaar 2012 {published data only}
-
- Bastelaar KMP, Pouwer F, Cuijpers P, Riper H, Twisk JWR, Snoek FJ. Is a severe clinical profile an effect modifier in a web‐based depression treatment for adults with type 1 or type 2 diabetes? Secondary analyses from a randomized controlled trial. Journal of Medical Internet Research 2012;14(1):e2. - PMC - PubMed
van Dijk 2013 {published data only}
-
- Dijk SEM, Pols AD, Adriaanse MC, Bosmans JE, Elders PJM, Marwijk HWJ, et al. Cost‐effectiveness of a stepped‐care intervention to prevent major depression in patients with type 2 diabetes mellitus and/or coronary heart disease and subthreshold depression: design of a cluster‐randomized controlled trial. BMC Psychiatry 2013;13:128‐36. - PMC - PubMed
References to ongoing studies
Dwinger 2013 {published data only}
-
- DRKS00000584. Evaluation of a telephonebased health coaching in chronic diseases. http://www.drks.de/DRKS00000584 (accessed 14 April 2016).
NCT00525304 {published data only}
-
- NCT00525304. A self‐management program for adults with both schizophrenia and a co‐occurring medical condition. https://www.clinicaltrials.gov/ct2/show/NCT00525304 (accessed 14 April 2016).
NCT01410357 {published data only}
-
- NCT01410357. Improving outcomes for individuals with serious mental illness and diabetes (TTIM). https://clinicaltrials.gov/ct2/show/NCT01410357 (accessed 14 April 2016).
NCT01725815 {published data only}
-
- NCT01725815. The Health Access and Recovery Peer program (HARP). https://clinicaltrials.gov/ct2/show/NCT01725815 (accessed 14 April 2016).
NCT01828931 {published data only}
-
- NCT01828931. Lifestyle intervention for diabetes and weight management in psychosis (Healthy LIFE). https://clinicaltrials.gov/ct2/show/NCT01828931 (accessed 14 April 2016).
NCT02011529 {published data only}
-
- NCT02011529. TEAMcare for diabetes in mental health centers. https://clinicaltrials.gov/ct2/show/NCT02011529 (accessed 14 April 2016).
NCT02127671 {published data only}
-
- NCT02127671. Intervention trial to decrease cardiovascular risk in persons with serious mental illness (IDEAL). https://clinicaltrials.gov/ct2/show/NCT02127671 (accessed 14 April 2016).
NCT02188732 {published data only}
-
- NCT02188732. Self‐management training and automated telehealth to improve SMI health outcomes. https://clinicaltrials.gov/ct2/show/NCT02188732 (accessed 14 April 2016).
NCT02318797 {published data only}
-
- NCT02318797. Optimizing behavioral health homes for adults with serious mental illness (PCORI OH). https://clinicaltrials.gov/ct2/show/NCT02318797 (accessed 14 April 2016).
Additional references
ADA 1999
-
- The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 1999;22:S5‐19. - PubMed
ADA 2008
-
- American Diabetes Association. Standards of medical care in diabetes ‐ 2008. Diabetes Care 2008;31:S12‐54. - PubMed
Ajzen 1991
-
- Ajzen I. The theory of planned behavior. Organisational Behavior and Human Decision Processes 1991;50:179‐211.
Anderson 2000
-
- Anderson RM, Funnell MM, Fitzgerald JT, Marrero DG. The Diabetes Empowerment Scale: a measure of psychosocial self‐efficacy. Diabetes Care 2000;23:739‐43. - PubMed
Bandura 1986
-
- Bandura A. Social. Social Foundations of Thought and Action: A Social Cognitive Theory. Upper Saddle River, NJ: Prentice‐Hall, 1986.
Barlow 2002
-
- Barlow JH. How to use education as an intervention in osteoarthritis. Balliere's Best Practice & Research. Clinical Rheumatology 2001;15(4):545‐8. - PubMed
Block 1990
-
- Block G, Hartman AM, Naughton D. A reduced dietary questionnaire: development and validation. Epidemiology 1990;1:58‐64. - PubMed
Boutron 2008
-
- Boutron I, Moher D, Altman DG, Schulz K, Ravaud P, for the CONSORT Group. Extending the CONSORT statement to randomized trials of nonpharmacologic treatment: explanation and elaboration. Annals of Internal Medicine 2008;148:295‐309. - PubMed
Buhagiar 2011
Busner 2007
Cimo 2012
Craig 2008
De Hert 2011
Deakin 2005
Dipietro 1993
-
- Dipietro L, Caspersen CJ, Ostfeld AM, Nadel ER. A survey for assessing physical activity among older adults. Medicine and Science in Sport and Exercise 1993;25(5):628‐42. - PubMed
Duke 2009
Eady 2008
Fitzgerald 1998
-
- Fitzgerald JT, Funnell MM, Hess GE, Barr PA, Anderson RM, Hiss RG, et al. The reliability and validity of a brief diabetes knowledge test. Diabetes Care 1998;21:706‐10. - PubMed
Goldberg 2007b
-
- Goldberg RW, Kreyenbuhl LA, Medoff DR, Dickerson FB, Wohlheiter K, Fang LJ, et al. Quality of diabetes care among adults with serious mental illness. Psychiatric Services 2007;58(4):536‐43. - PubMed
Hamilton 1960
Hedges 1985
-
- Hedges LV, Olkin I. Statistical Methods for Meta‐analysis. New York: Academic Press, 1985.
Higgins 2002
-
- Higgins JPT, Thompson SG. Quantifying heterogeneity in a meta‐analysis. Statistics in Medicine 2002;21:1539‐58. - PubMed
Higgins 2003
Higgins 2009
Higgins 2011a
-
- Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. www.cochrane‐handbook.org.
Higgins 2011b
Hoffman 2014
-
- Hoffman TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ 2014;348:g1687. - PubMed
Hróbjartsson 2013
-
- Hróbjartsson A, Thomsen AS, Emanuelsson F, Tendal B, Hilden J, Boutron I, et al. Observer bias in randomized clinical trials with measurement scale outcomes: a systematic review of trials with both blinded and nonblinded assessors. Canadian Medical Association Journal 2013;185:E201‐11. - PMC - PubMed
International Diabetes Federation 2015
-
- International Diabetes Federation. Diabetes: A global emergency. IDF Diabetes Atlas, 7th edition. Brussels, Belgium: International Diabetes Federation, 2015.
Kay 1987
-
- Kay SR, Flszbein A, Opfer LA. The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin 1987;13(2):261‐76. - PubMed
Kirkham 2010
-
- Kirkham JJ, Dwan KM, Altman DG, Gamble C, Dodd S, Smyth R, et al. The impact of outcome reporting bias in randomised controlled trials on a cohort of systematic reviews. BMJ 2010;340:c365. - PubMed
Lawrence 2009
Leventhal 1984
-
- Leventhal H, Nerenz DR, Steele DF. Illness representations and coping with health threats. In: Baum A, Singer J editor(s). A Handbook of Psychology and Health. Hillsdales, NJ: Erlbaum, 1984:219‐52.
Liberati 2009
Mattis 1973
-
- Mattis S. Dementia Rating Scale. Psychological Assessment Resources, Inc., Odessa, FL, 1973.
McBain 2014
McHorney 1993
-
- McHorney CA, Ware JE, Raczek AE. The MOS 36‐item short‐form health survey: II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Medical Care 1993;31:247‐63. - PubMed
McKibbin 2006
-
- McKibbin CL, Patterson TL, Norman G, Patrick K, Jin H, Roesch S, et al. A lifestyle intervention for older schizophrenia patients with diabetes mellitus: a randomized controlled trial. Schizophrenia Research 2006;86:36‐44. - PubMed
Meader 2014
Meadows 2000
-
- Meadows KA, Abrams C, Sandbaek A. Adaptation of the Diabetes HealthProfile (DHP‐1) for use with patients with type 2 diabetes mellitus: psychometric evaluation and cross‐cultural comparison. Diabetic Medicine 2000;17:572‐80. - PubMed
Michie 2010
-
- Michie S, Prestwich A. Are interventions theory based? Development of a theory coding scheme. Health Psychology 2010;29:1‐8. - PubMed
Michie 2013
-
- Michie S, Johnston M, Abraham C, Francis J, Eccles MP. The behaviour change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behaviour change interventions. Annals of Behavioural Medicine 2013;46:81‐95. - PubMed
NHS Diabetes 2011
-
- NHS Diabetes. Commissioning Mental Health and Diabetes Services. London: NHS Diabetes, 2011.
NICE 2015
-
- National Institute for Health and Care Excellence. Type 2 Diabetes in Adults: Management. London: NICE, 2015. - PubMed
Osborn 2008
Pal 2013
Peel 2004
Prochaska 1997
-
- Prochaska JO, Velicer WF. The transtheoretical model of health behaviour change. American Journal of Health Promotion 1997;12:38‐48. - PubMed
Rao 1992
-
- Rao JNK, Scott AJ. A simple method for the analysis of clustered binary data. Biometrics 1992;48:577‐85. - PubMed
Riley 2011
-
- Riley RD, Higgins JP, Deeks JJ. Interpretation of random effects meta‐analyses. BMJ 2011;342:d549. - PubMed
Royal College of Psychiatrists 2009
-
- Royal College of Psychiatrists. OP67 Physical Health in Mental Health: Final Report of a Scoping Group. London: Royal College of Psychiatrists, 2009.
Steed 2003
-
- Steed L, Cooke D, Newman S. A systematic review of psychosocial outcomes following education, self‐management and psychological interventions in diabetes mellitus. Patient Education and Counseling 2003;51:5‐15. - PubMed
Steinsbekk 2012
Sterne 2011
-
- Sterne JA, Sutton AJ, Ioannidis JP, Terrin N, Jones DR, Lau J, et al. Recommendations for examining and interpreting funnel plot asymmetry in meta‐analyses of randomised controlled trials. BMJ 2011;343:d4002. - PubMed
The Emerging Risk Factors Collaboration 2010
The Schizophrenia Commission 2012
-
- The Schizophrenia Commission. The Abandoned Illness: a Report by the Schizophrenia Commission. London: Rethink Mental Illness, 2012.
Thorpe 2013
Toobert 2000
-
- Toobert DJ, Hampson SE, Glasgow RE. The summary of diabetes self‐care activities measure: results from 7 studies and a revised scale. Diabetes Care 2000;23:943‐50. - PubMed
Ware 1992
-
- Ware JE, Sherbourne CD. The MOS 36‐item short‐form health survey (SF‐36): I. Conceptual framework and item selection. Medical Care 1992;30(6):473‐83. - PubMed
WHO 1998
-
- Alberti KM, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part I: diagnosis and classification of diabetes mellitus. Provisional report of a WHO consultation. Diabetic Medicine 1998;15:539‐53. - PubMed
WHO 2013a
-
- World Health Organization. Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013‐2020. Geneva, Switzerland: WHO Press, 2013.
WHO 2013b
-
- World Health Organization. Mental Health Action Plan 2013‐2020. Geneva, Switzerland: WHO Press, 2013.
Wild 2004
-
- Wild S, Roglie G, Green A, Sicree R, King H. Global prevalence of diabetes estimates for the year 2000 and projections for 2030. Diabetes Care 2004;27:1047‐53. - PubMed
Wing 1998
-
- Wing KJ, Beevor AS, Curtis RH, Park SB, Hadden S, Burns A. Health of the Nation Outcome Scale (HoNOS). Research and development. British Journal of Psychiatry 1998;172:11‐8. - PubMed
Wong 2006a
Wong 2006b
-
- Wong SSL, Wilczynski N, Haynes RB. Optimal CINAHL search strategies for identifying therapy studies and review articles. Journal of Nursing Scholarship 2006;38(2):194‐9. - PubMed
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
