Relevant patient characteristics for guiding tailored integrated diabetes primary care: a systematic review

Research output: Contribution to journal(Systematic) Review article peer-review

4 Citations (Web of Science)

Abstract

Aim To identify which patient-related effect modifiers influence the outcomes of integrated care programs for type 2 diabetes in primary care. Background Integrated care is a widespread management strategy for the treatment of type 2 diabetes. However, most integrated care programs are not tailored to patients' needs, preferences and abilities. There is increasing consensus that such a patient-centered approach could improve the management of type 2 diabetes. Thus far, it remains unclear which patient-related effect modifiers should guide such an approach. Methods PubMed, CINAHL and EMBASE were searched for empirical studies published after 1998. A systematic literature review was conducted according to the PRISMA guidelines. Findings In total, 23 out of 1015 studies were included. A total of 21 studies measured the effects of integrated diabetes care programs on hemoglobin A1c (HbA1c) and three on low-density lipoprotein cholesterol, systolic blood pressure and health-care utilization. In total, 49 patient characteristics were assessed as potential effect modifiers with HbA1c as an outcome, of which 46 were person or health-related and only three were context-related. Younger age, insulin therapy and longer disease duration were associated with higher HbA1c levels in cross-sectional and longitudinal studies. Higher baseline HbA1c was associated with higher HbA1c at follow-up in longitudinal studies. Information on context- and person-related characteristics was limited, but is necessary to help identify the care needs of individual patients and implement an effective integrated type 2 diabetes tailored care program.

Original languageEnglish
Pages (from-to)424-447
Number of pages24
JournalPrimary health care research & development
Volume19
Issue number5
DOIs
Publication statusPublished - Sep 2018

Keywords

  • integrated health-care systems
  • patient-centered care
  • primary care
  • review
  • type 2 diabetes mellitus
  • POOR GLYCEMIC CONTROL
  • PERSON-CENTERED CARE
  • HIGH-RISK PATIENTS
  • DISEASE-MANAGEMENT
  • GENERAL-PRACTICE
  • OLDER-ADULTS
  • TYPE-2
  • HEALTH
  • PREDICTORS
  • PROJECT

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