title: Shared medical appointments for children and adolescents with type 1 diabetes: perspectives and experiences of patients, parents, and health care providers.
abstract: OBJECTIVE
  This study examined the perspectives and experiences of patients, parents, and health care providers with shared medical appointments (SMAs) for children and adolescents with type 1 diabetes. Specifically studied were reasons to attend SMAs, perceived differences between SMAs and individual medical appointments, patient-valued health care aspects, and providers' performance.
  
  
  METHODS
  Fifty-two patients, 8 parents, and 36 health care providers participated. Perspectives on SMAs were assessed with questionnaires and an online focus group. Data was analyzed using descriptive statistics.
  
  
  RESULTS
  Health care providers had work-related reasons to conduct SMAs. Patients and parents primarily valued the presence of other patients during SMAs. According to health care providers and patients, a higher or similar amount of information was discussed during SMAs as opposed to individual appointments, respectively. SMAs did contain more discussion about lifestyle. Most consultation aspects considered important by the patients were performed by their health care providers. Patient satisfaction with SMAs did tend to decrease after 3 months. Parents were somewhat more critical about SMAs.
  
  
  CONCLUSIONS
  Health care providers, patients, and parents were generally positive about SMAs. Future studies should examine the impact of the presence of parents and different health care providers during SMAs, and that of differences in patient age, type of insulin treatment, and disease-related problems.
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
authors.forename: Arlene
authors.initials: A
authors.lastname: Mejino
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
authors.forename: Janneke
authors.initials: J
authors.lastname: Noordman
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands ; Radboud University Nijmegen Medical Centre, Department of Primary and Community Care, Nijmegen, The Netherlands ; Department of Health Science, Buskerud University College, Drammen, Norway.
authors.forename: Sandra
authors.initials: S
authors.lastname: van Dulmen
keywords: adolescent; child; diabetes mellitus type 1; pediatrics; shared medical appointment