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Interventions to Improve the Management of Diabetes in Primary Care, Outpatient, and Community Settings
Open accessAbstract
OBJECTIVE—To review the effectiveness of interventions targeted at health care professionals and/or the structure of care in order to improve the management of diabetes in primary care, outpatient, and community settings. RESEARCH DESIGN AND METHODS—A systematic review of controlled trials evaluating the effectiveness of interventions targeted at health care professionals and aimed at improving the process of care or patient outcomes for patients with diabetes was performed. Standard search methods of the Cochrane Effective Practice and Organization of Care Group were used. RESULTS—A total of 41 studies met the inclusion criteria. The studies identified were heterogeneous in terms of interventions, participants, settings, and reported outcomes. In all studies, the interventions were multifaceted. The interventions were targeted at health care professionals only in 12 studies, at the organization of care only in 9 studies, and at both in 20 studies. Complex professional interventions improved the process of care, but the effect on patient outcomes remained less clear because such outcomes were rarely assessed. Organizational interventions that facilitated the structured and regular review of patients also showed a favorable effect on process measures. Complex interventions in which patient education was added and/or the role of a nurse was enhanced led to improvements in patient outcomes as well as the process of care. CONCLUSIONS—Multifaceted professional interventions and organizational interventions that facilitate structured and regular review of patients were effective in improving the process of care. The addition of patient education to these interventions and the enhancement of the role of nurses in diabetes care led to improvements in patient outcomes and the process of care.
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“Interventions that were complex were often associated with lower adoption [3, 35, 39, 87, 88].”
From Achieving change in primary care—causes of the evidence to practice gap: systematic reviews of reviews (2015) · cites this paper as [87]
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Metadata
- Authors
- Renders, C. M., Valk, G. D., Griffin, S. J., Wagner, E. H., Eijk van, J. T., & Assendelft, W. J. J.
- Affiliations
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- University of Cambridge (GB)
- Group Health Cooperative (US)
- Department of Medical Sociology, Universiteit van Maastricht, Maastricht, the Netherlands
- Amsterdam UMC Location University of Amsterdam (NL)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2001-10-01
- Volume
- 24
- Issue
- 10
- Pages
- 1821-1833
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2117186085
- Cited by
- 1,066
- References
- 73
- Citations by year
- 2026: 9 · 2025: 10 · 2024: 8 · 2023: 13 · 2022: 18 · 2021: 24 · 2020: 21 · 2019: 38 · 2018: 27 · 2017: 40 · 2016: 46 · 2015: 62 · 2014: 65 · 2013: 60 · 2012: 63
- FWCI
- 5.00
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Medicine › Family Practice › Primary Care and Health Outcomes
- Keywords
- diabetes management, primary care, outpatient care, community settings, organizational interventions, process of care, patient outcomes, multicomponent intervention, patient education, nursing role
- MeSH terms
- Ambulatory Care, Community Health Services, Diabetes Mellitus, Humans, Patient Education as Topic, Primary Health Care, Quality of Health Care, Treatment Outcome, Controlled Clinical Trials as Topic
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