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A relationship between long-term metformin use and vitamin B12 deficiency has been long discussed in the literature. Nonetheless, prior to 2022, there was no official guidance. In June 2022, the Medicines and Healthcare products Regulatory Agency (MHRA) published advice, stating that low vitamin B12 is now considered to be a common side effect. It advises checking levels in patients with symptoms of B12 deficiency, as well as monitoring those at risk of B12 deficiency.
Despite efforts to promote evidence-based practice, there is still a gap in the translation of research findings into policies and clinical practice. The above research has been shared widely in the academic and specialist diabetes literature over a prolonged period. The purpose of the scoping review is to explore what evidence is available regarding clinicians’ awareness of the association between metformin use and vitamin B12 deficiency in patients with type 2 diabetes mellitus, how this evidence is implemented into frontline clinical practice and what screening processes are recommended or exist.
This is a protocol for a scoping review to be guided by the Joanna Briggs Institute (JBI) methodology for scoping reviews 20. The databases to be searched will include MEDLINE (accessed via PubMed), British Nursing Index, Google Scholar, Cochrane, Embase, Web of Science and Cumulative Index to Nursing and Allied Health Literature (CINAHL) (accessed via EBSCO), alongside searching for grey literature such as Electronic Theses Online Service (EThOS), DART European and Kings College London Research Portal. Titles and abstracts of articles will be reviewed by the authors. If articles are representative of the inclusion criteria, the articles will go through a full-text review by the authors. The results of the search and study inclusion/exclusion process will be reported and presented in a Preferred Reporting Items for Systematic Reviews and Meta-analyses flow diagram. Data will be extracted from papers, using the recommended JBI data extraction tool. The search will commence in August 2025, and the review is expected to be completed by November 2025.
The search will commence in August 2025, and the review is expected to be completed by November 2025.
As this is a scoping review protocol that did not involve any human participants, human data or human tissue, no ethical approval was required. Our dissemination strategy includes peer review publication, presentation at conferences and with relevant stakeholders.
The COVID-19 pandemic prompted a significant increase in the use of remote consultations—by telephone or video—in both primary and secondary healthcare. The reported advantages of remote consulting for both patients and clinicians include greater efficiency, flexibility and convenience. However, disadvantages, such as the uncertainty created by a loss of face-to-face contact, have also been highlighted. The aim of this study was to explore, explain and interpret patients’ and clinicians’ perceptions and experiences of remote consultations and assist decision-making about their future use.
A qualitative study based on semistructured online interviews.
Primary mental healthcare or secondary care cardiology services, London, UK, February–March 2022.
Primary care mental health patients (n=5), primary care clinicians (general practitioners) (n=15), secondary care cardiology patients (n=9) and secondary care cardiology clinicians (n=5).
The results demonstrate that a range of factors have influenced the experiences of both clinicians and patients and indicate shifts in the norms of professional practice and clinician–patient relationships.
Patients and clinicians demonstrated pragmatic acceptance of remote consultations and, looking forward, a preference for a balanced ‘hybrid model’ of remote and face-to-face appointments. The study also highlights a need to consolidate and build on the informal learning and adaptation to remote consulting that has already taken place.
To describe how specialised models of registered nurse-led care and support can play a vital role in the health and quality of life of someone with intellectual disability and multiple chronic and complex health problems.
Single instrumental case study.
Data collection occurred between March and August 2023, and included interviews with parents, historical case files, descriptions of the nurse-led model of care and a list of the daily registered nurse-led interventions.
The evidence presented strongly support the positive impact a nurse-led model of care can have for persons with profound disability and complex health conditions, and their families. The improved quality of life observed in this project underscores the significant role nurses play in enhancing the well-being of this vulnerable population.
Further research on a larger scale should be completed to create a robust foundation of a specialised, nurse-led model of care for individuals with profound disability and complex health conditions.
There is room for funded intermediate models of care as the health system cannot be expected, and nor is it appropriate, to provide ongoing care for all people with intellectual disability.
This study adhered to the COREQ guidelines for qualitative research.
No patient or public contribution.
To explore the experiences of partnership nursing among nurses when caring for children and young people with long-term conditions, and their families.
Partnership nursing is promoted as a positive model of care among paediatric nurses, where shared roles and decision-making, parental participation, mutual trust and respect, communication and negotiation are valued to create positive care experiences and enhance patient outcomes. Little is known about how nurses use partnership with both the patient and the parents in this triad to deliver partnership nursing.
A qualitative systematic review followed Joanna Briggs Institute meta-aggregation approach and has been reported according to PRISMA guidelines.
A comprehensive systematic search was conducted in seven electronic databases. Studies were assessed according to a pre-determined inclusion criteria. Qualitative findings with illustrative participant quotes were extracted from included studies and grouped into categories to inform overall synthesised findings. Methodological quality assessment was conducted.
A total of 5837 publications were screened, and 41 qualitative studies were included. Three overarching synthesised findings were identified: (1) Using education to promote feelings of safety and support, (2) Partnering to develop a strong therapeutic relationship and (3) Optimising communication underpinned by shared decision-making principles to deliver individualised care.
Nurses demonstrated successful partnership in their practice, but focused on developing dyadic nurse–parent and dyadic nurse–child partnerships. Future practice development that creates a three-way triadic partnership may aid therapeutic relationships and shared decision-making.
Clinicians can reflect on how dyadic partnerships (focusing on the child or the parent) may exclude opportunities for coherent care. Further exploration in practice, policy and research as to how nurses determine child competency and child and parent level of engagement in triadic partnership may improve the potential of meaningful shared decision-making.
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