Prim Health Care Res Dev .

ISSN:

国家:

Netherlands

影响因子:

SCIE收录情况:

JCR分区:

Dorijn F L Hertroijs; Arianne M J Elissen; Martijn C G J Brouwers; Nicolaas C Schaper; Dirk Ruwaard; Dorijn F L Hertroijs; Arianne M J Elissen; Martijn C G J Brouwers; Nicolaas C Schaper; Dirk Ruwaard
2018-9 相关链接

摘要

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.

integrated health-care systems; patient-centered care; primary care; review; type 2 diabetes mellitus.

医疗护理 ; 慢性非传染性疾病

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