Implementation of locally adapted guidelines on type 2 diabetes
Open accessAbstract
OBJECTIVE: To assess the effects of a facilitator enhanced multifaceted intervention to implement a locally adapted guideline on the shared care for people with type 2 diabetes. METHODS: During 1 year a cluster-randomized trial was performed in 30 general practices. In the intervention group, nurse facilitators enhanced guideline implementation by analysing barriers to change, introducing structured care, training practice staff and giving performance feedback. Targets for HbA1c%, systolic blood pressure as well as indications for angiotensin converting enzyme/angiotensin receptor blocking agent prescription differed from the national guidelines. In the control group, GPs were asked to continue the care for people with diabetes as usually. Generalized estimating equations were used to control for the clustered design of the study. RESULTS: In the intervention group, more people were seen on a 3-monthly basis (88% versus 69%, P < 0.001) and more blood pressure and bodyweight measurements were performed every 3 months (blood pressure 83% versus 66%, P < 0.001 and bodyweight 78.9% versus 48.5%, P < 0.001). Apart from a marginal difference in mean cholesterol, differences in HbA1c%, blood pressure, body mass index and treatment satisfaction were not significant. CONCLUSION: Multifaceted implementation of locally adapted shared care guidelines did improve the process of diabetes care but hardly changed intermediate outcomes. In the short term, local adaptation of shared care guidelines does not improve the cardiovascular risks of people with type 2 diabetes.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In van Bruggen 2008, baseline outcomes were at unclear risk of bias.
“Baseline outcomes Unclear risk No baseline data”
From Tailored interventions to address determinants of practice (2015) · cites this paper as van Bruggen 2008
In van Bruggen 2008, blinding of outcome assessment was at unclear risk of bias.
“Blinding of outcome assessment (detection bias) All outcomes Unclear risk There is no information on blinding of data collection”
From Tailored interventions to address determinants of practice (2015) · cites this paper as van Bruggen 2008
In van Bruggen 2008, random sequence generation was at unclear risk of bias.
“Random sequence generation (selection bias) Unclear risk A random number table was used”
From Tailored interventions to address determinants of practice (2015) · cites this paper as van Bruggen 2008
In van Bruggen 2008, allocation concealment was at low risk of bias.
“Allocation concealment (selection bias) Low risk Allocation was undertaken by an independent researcher”
From Tailored interventions to address determinants of practice (2015) · cites this paper as van Bruggen 2008
In van Bruggen 2008, baseline characteristics were at low risk of bias.
“Baseline characteristics Low risk Patient characteristics comparable except for education and macrovascular complications (adjusted for)”
From Tailored interventions to address determinants of practice (2015) · cites this paper as van Bruggen 2008
In van Bruggen 2008, other bias was at low risk of bias.
“Other bias Low risk Baseline characteristics similar; low likelihood of contamination”
From Tailored interventions to address determinants of practice (2015) · cites this paper as van Bruggen 2008
In van Bruggen 2008, overall risk of bias was unclear.
“Risk of bias overall Unclear risk 4 criteria unclear risk”
From Tailored interventions to address determinants of practice (2015) · cites this paper as van Bruggen 2008
In van Bruggen 2008, selective reporting was at low risk of bias.
“Selective reporting (reporting bias) Low risk Appropriate outcomes reported”
From Tailored interventions to address determinants of practice (2015) · cites this paper as van Bruggen 2008
In van Bruggen 2008, contamination was at low risk of bias.
“Contamination Low risk General practices were randomised”
From Tailored interventions to address determinants of practice (2015) · cites this paper as van Bruggen 2008
In van Bruggen 2008, incomplete outcome data was at low risk of bias.
“Incomplete outcome data (attrition bias) All outcomes Low risk No practices withdrew”
From Tailored interventions to address determinants of practice (2015) · cites this paper as van Bruggen 2008
Cites
EuroQol: the current state of play
Brooks, R. (1996) · Health Policy · doi:10.1016/0168-8510(96)00822-6 · Cited by 5,815 · see citing works
From best evidence to best practice: effective implementation of change in patients' care
Grol, R., & Grimshaw, J. (2003) · The Lancet · doi:10.1016/s0140-6736(03)14546-1 · Cited by 4,531 · see citing works
The American Journal of Managed Care
(2020) · The American Journal of Managed Care · doi:10.37765/ajmc · Cited by 3,238 · see citing works
Effect of clinical guidelines on medical practice: a systematic review of rigorous evaluations
Grimshaw, J., & Russell, I. T. (1993) · The Lancet · doi:10.1016/0140-6736(93)92244-n · Cited by 2,791 · see citing works
Review: a gentle introduction to imputation of missing values.
Donders, A. R. T., van der Heijden, G. J. M. G., Stijnen, T., & Moons, K. G. M. (2006) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2006.01.014 · Cited by 2,582 · see citing works
(2001) · PubMed · Cited by 1,709 · see citing works
Successes and Failures in the Implementation of Evidence-Based Guidelines for Clinical Practice
Grol, R. (2001) · Medical Care · doi:10.1097/00005650-200108002-00003 · Cited by 1,233 · see citing works
Renders, C. M., Valk, G. D., Griffin, S. J., Wagner, E. H., Eijk van, J. T., & Assendelft, W. J. J. (2001) · Diabetes Care · doi:10.2337/diacare.24.10.1821 · Cited by 1,066 · see citing works
Regression with Missing X 's: A Review
Little, R. J. A. (1992) · Journal of the American Statistical Association · doi:10.1080/01621459.1992.10476282 · Cited by 968 · see citing works
Printed educational materials: effects on professional practice and healthcare outcomes
Giguere, A. M. C., Légaré, F., Grimshaw, J., Turcotte, S., Fiander, M., Grudniewicz, A., Makosso‐Kallyth, S., Wolf, F. M., Farmer, A. P., & Gagnon, M. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004398.pub3 · Cited by 879 · see citing works
Health-Related Quality of Life and Treatment Satisfaction in Dutch Patients With Type 2 Diabetes
Redekop, K., Koopmanschap, M. A., Stolk, R. P., Rutten, G. E. H. M., Wolffenbuttel, B. H. R., & Niessen, L. W. (2002) · Diabetes Care · doi:10.2337/diacare.25.3.458 · Cited by 565 · see citing works
Self-citationThe effectiveness of disease and case management for people with diabetesA systematic review
Norris, S. L., Nichols, P., Caspersen, C. J., Glasgow, R. E., Engelgau, M. M., Jack, L., Isham, G. J., SNYDER, S., Carande-Kulis, V. G., & GARFIELD, S. A. (2002) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(02)00423-3 · Cited by 496 · see citing works
Clinical Inertia in Response to Inadequate Glycemic Control
Shah, B. R., Hux, J. E., Laupacis, A., Zinman, B., & van Walraven, C. (2005) · Diabetes Care · doi:10.2337/diacare.28.3.600 · Cited by 387 · see citing works
Randomised controlled trial of structured personal care of type 2 diabetes mellitus
Olivarius, N. D. F., Beck-Nielsen, H., Andreasen, A., Hørder, M., & Pedersen, P. A. (2001) · British medical journal · doi:10.1136/bmj.323.7319.970 · Cited by 323 · see citing works
Quality of Diabetes Care in U.S. Academic Medical Centers
Grant, R. W., Buse, J. B., Meigs, J. B., & for the University HealthSystem Consortium (UHC) Diabetes Benchmarking Project Team (2005) · Diabetes Care · doi:10.2337/diacare.28.2.337 · Cited by 311 · see citing works
Cardiovascular Fitness as a Predictor of Mortality in Men
Laukkanen, J. A., Lakka, T. A., Rauramaa, R., Kuhanen, R., Venäläinen, J. M., Salonen, R. M., & Salonen, J. T. (2001) · Archives of Internal Medicine · doi:10.1001/archinte.161.6.825 · Cited by 291 · see citing works
Improving the Management of Chronic Disease at Community Health Centers
Landon, B. E., Hicks, L. S., O’Malley, A. J., Lieu, T. A., Keegan, T., McNeil, B. J., & Guadagnoli, E. (2007) · New England Journal of Medicine · doi:10.1056/nejmsa062860 · Cited by 280 · see citing works
Greenfield, S., Kaplan, S. H., Kahn, R., Ninomiya, J. K., & Griffith, J. L. (2002) · Annals of Internal Medicine · doi:10.7326/0003-4819-136-2-200201150-00008 · Cited by 224 · see citing works
Burgers, J. S., Bailey, J., Klazinga, N., van der Bij, A. K., Grol, R. P. T. M., & Feder, G. S. (2002) · Diabetes Care · doi:10.2337/diacare.25.11.1933 · Cited by 198 · see citing works
A systematic review of diabetes disease management programs.
Knight, K. K., Badamgarav, E., Henning, J. M., Hasselblad, V., Gano, A. D., Ofman, J. J., & Weingarten, S. R. (2005) · PubMed · Cited by 189 · see citing works
Optimal Methods for Guideline Implementation
Gross, P. A., Greenfield, S., Cretin, S., Ferguson, J., Grimshaw, J., Grol, R. P. T. M., Klazinga, N., Lorenz, W., Meyer, G. S., Riccobono, C. A., et al. (2001) · Medical Care · doi:10.1097/00005650-200108002-00006 · Cited by 168 · see citing works
Achievable benchmarks of care: the ABC<SUP>TM</SUP>s of benchmarking
Weissman, N. W., Allison, J. J., Kiefe, C. I., Farmer, R. M., Weaver, M. T., Williams, O. D., Child, I. G., Pemberton, J. H., Brown, K. C., & Baker, C. S. (1999) · Journal of Evaluation in Clinical Practice · doi:10.1046/j.1365-2753.1999.00203.x · Cited by 167 · see citing works
Methodology matters-XII. Identifying achievable benchmarks of care: concepts and methodology
Kiefe, C. I., Weissman, N., Allison, J. J., Farmer, R. M., Weaver, M. T., & Williams, O. (1998) · International Journal for Quality in Health Care · doi:10.1093/intqhc/10.5.443 · Cited by 128 · see citing works
The North Dublin randomized controlled trial of structured diabetes shared care
Smith, S. M. (2004) · Family Practice · doi:10.1093/fampra/cmh109 · Cited by 120 · see citing works
Implementing Practice Guidelines for Appropriate Antimicrobial Usage
Gross, P. A., & Pujat, D. (2001) · Medical Care · doi:10.1097/00005650-200108002-00004 · Cited by 100 · see citing works
O’Connor, P. J., DESAI, J. R., Solberg, L. I., Reger, L. A., Crain, A. L., Asche, S. E., Pearson, T. L., Clark, C., Rush, W. A., Cherney, L. M., et al. (2005) · Diabetes Care · doi:10.2337/diacare.28.8.1890 · Cited by 84 · see citing works
Freemantle, N., Harvey, E., Wolf, F. M., Grimshaw, J., Grilli, R. G., & Bero, L. A. (2005) · UCL Discovery (University College London) · Cited by 80 · see citing works
Shared care with task delegation to nurses for type 2 diabetes: prospective observational study.
Ubink-Veltmaat, L. J., Bilo, H. J. G., Groenier, K. H., Rischen, R., & Jong, B. M. (2005) · PubMed · Cited by 79 · see citing works
Performance Measurement in Search of a Path
Hayward, R. A. (2007) · New England Journal of Medicine · doi:10.1056/nejme068285 · Cited by 72 · see citing works
Bouma, M., Rutten, G. E. H. M., de Grauw, W. J. C., Wiersma, T., & Goudswaard, A. N. (1999) · PubMed · Cited by 69 · see citing works
Self-citationThe effectiveness of local adaptation of nationally produced clinical practice guidelines
Silagy, C. A. (2002) · Family Practice · doi:10.1093/fampra/19.3.223 · Cited by 66 · see citing works
Frijling, B. D., Lobo, C. M., Hulscher, M., Akkermans, R., Braspenning, J. C. C., Prins, A., van der Wouden, J. C., & Grol, R. P. T. M. (2002) · Diabetic Medicine · doi:10.1046/j.1464-5491.2002.00810.x · Cited by 65 · see citing works
Goddijn, P. P. M., Bilo, H. J. G., Meadows, K., et al. (1996) · Quality of Life Research · doi:10.1007/bf00449918 · Cited by 40 · see citing works
How to implement change in clinical practice
Powell, C. (2003) · Paediatric Respiratory Reviews · doi:10.1016/s1526-0542(03)00092-7 · Cited by 38 · see citing works
Groeneveld, Y., Petri, H., Hermans, J., & Springer, M. P. (2001) · Scandinavian Journal of Primary Health Care · doi:10.1080/028134301300034585 · Cited by 38 · see citing works
Metabolic control and morbidity of Type 2 diabetic patients in a general practice network
Bouma, M. (1999) · Family Practice · doi:10.1093/fampra/16.4.402 · Cited by 35 · see citing works
Improving glycaemic control in patients with Type 2 diabetes mellitus without insulin therapy
Goudswaard, A. N., Stolk, R. P., de Valk, H. W., & Rutten, G. E. H. M. (2003) · Diabetic Medicine · doi:10.1046/j.1464-5491.2003.00980.x · Cited by 33 · see citing works
Self-citationImplementing practice guidelines.
Anderson, G. (1993) · PubMed · Cited by 31 · see citing works
Standards of Care or Standard Care? Guidelines in general practice
Grol, R. P. T. M. (1993) · Scandinavian Journal of Primary Health Care · doi:10.3109/02813439308997646 · Cited by 10 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Audit and feedback: effects on professional practice and healthcare outcomes
Ivers, N., Jamtvedt, G., Flottorp, S., Young, J. M., Odgaard-Jensen, J., French, S. D., O'Brien, M. A., Johansen, M., Grimshaw, J., & Oxman, A. D. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000259.pub3 · Cited by 5,485 · see citing works
Tailored interventions to address determinants of practice
Baker, R., Camosso-Stefinovic, J., Gillies, C., Shaw, E. J., Cheater, F., Flottorp, S., Robertson, N., Wensing, M., Fiander, M., Eccles, M. P., et al. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005470.pub3 · Cited by 711 · see citing works
- Authors
- van Bruggen, R., Gorter, K. J., Stolk, R. P., Verhoeven, R. P., & Rutten, G. E. H. M.
- Affiliations
- University Medical Center Utrecht (NL)
- University Medical Center Groningen (NL)
- Gelre Hospitals (NL)
- Venue
- Family Practice
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-12-01
- Volume
- 25
- Issue
- 6
- Pages
- 430-437
- ISSN
- 0263-2136 (ISSN-L)
- 1460-2229
- OpenAlex
- W2165721722
- Cited by
- 55
- References
- 39
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 1 · 2023: 3 · 2022: 1 · 2021: 1 · 2020: 3 · 2019: 3 · 2018: 1 · 2017: 2 · 2016: 2 · 2015: 6 · 2014: 2 · 2013: 4 · 2012: 7
- FWCI
- 4.62
- Type
- journal article
- Language
- en
- Open access
- green
- research.rug.nl
- Licence
- other-oa
- Locations
- Family Practice (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- type 2 diabetes, guideline implementation, shared care, nurse facilitators, multicomponent intervention, HbA1c, blood pressure, ACE inhibitors, angiotensin receptor blockers, cardiovascular risk, general practice
- MeSH terms
- Aged, Diabetes Mellitus, Type 2, Educational Status, Family Practice, Female, Humans, Male, Middle Aged, Office Visits, Outcome and Process Assessment, Health Care, Patient Care Team, Patient Compliance, Disease Management, Guideline Adherence
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
